Yoshida Hitoshi, Koike Midori, Tada Yuma, Nakata Keiichi, Hino Akihisa, Fuji Shigeo, Masaie Hiroaki, Oka Chihiro, Higeno Akemi, Idota Atsushi, Yamasaki Tomoyuki, Ishikawa Jun
Department of Hematology, Osaka International Cancer Institute, Osaka, Japan.
Department of Laboratory, Osaka International Cancer Institute, Osaka, Japan.
Int J Hematol Oncol Stem Cell Res. 2020 Jan 1;14(1):1-10.
Advances of allogeneic hematopoietic cell transplantation (allo-HCT) have brought long-term survival to the patients with hematologic malignancies. Chronic graft-versus-host disease (GVHD) is one of major problems for the long- term survivors after allo-HCT. Dysregulation of immune reconstitution has been reported to be involved in the pathogenesis of chronic GVHD. Differences of immune reconstitution between cord blood transplantation (CBT) and unrelated bone marrow transplantation (UBMT) remain unclear in long-term survivors. We investigated immune reconstitution in patients surviving for more than 2 years after CBT (n=21) or UBMT (n=20) without relapse of underlying disease. Using flow cytometric analysis of peripheral blood, we investigated immune reconstitution of T cells, B cells, and NK cells between CBT and UBMT patients. We collected clinical data regarding allo-HCT and examined the relation of immune reconstitution to the development of chronic GVHD. Between CBT and UBMT patients, we found significant differences in absolute cell number of CD8+ as well as CD19+ cell and CD4/CD8 ratio even more than 2 years after allo-HCT. Among UBMT patients, absolute cell number of naive CD4+ cell was significantly lower in patients with chronic GVHD. In addition, we found significant differences in absolute cell number of CD19+ cell, especially naive B cell between patients with and without chronic GVHD in both CBT and UBMT patients. These results suggest that differences of immune recovery between CBT and UBMT patients may exist even in patients surviving for more than 2 years and might be related to the development of chronic GVHD.
异基因造血细胞移植（allo-HCT）的进展已使血液系统恶性肿瘤患者获得长期生存。慢性移植物抗宿主病（GVHD）是allo-HCT后长期存活者面临的主要问题之一。据报道，免疫重建失调参与了慢性GVHD的发病机制。在长期存活者中，脐血移植（CBT）和非亲缘骨髓移植（UBMT）之间免疫重建的差异仍不清楚。我们调查了CBT（n = 21）或UBMT（n = 20）后存活超过2年且基础疾病未复发患者的免疫重建情况。通过对外周血进行流式细胞术分析，我们研究了CBT和UBMT患者T细胞、B细胞和NK细胞的免疫重建情况。我们收集了有关allo-HCT的临床数据，并检查了免疫重建与慢性GVHD发生之间的关系。在CBT和UBMT患者之间，我们发现即使在allo-HCT后超过2年，CD8 +以及CD19 +细胞的绝对细胞数和CD4/CD8比值仍存在显著差异。在UBMT患者中，慢性GVHD患者的幼稚CD4 +细胞绝对细胞数显著降低。此外，我们发现CBT和UBMT患者中，有或无慢性GVHD的患者之间CD19 +细胞，尤其是幼稚B细胞的绝对细胞数存在显著差异。这些结果表明，即使在存活超过2年的患者中，CBT和UBMT患者之间的免疫恢复差异可能仍然存在，并且可能与慢性GVHD的发生有关。
