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异基因造血干细胞移植后IgG亚类的动力学及其对感染发生率的影响。

Kinetics of IgG subclasses and their effects on the incidence of infection after allogeneic hematopoietic stem cell transplantation.

作者信息

Koh Shiro, Koh Hideo, Nanno Satoru, Okamura Hiroshi, Nakashima Yasuhiro, Nakamae Mika, Hirose Asao, Hino Masayuki, Nakamae Hirohisa

机构信息

Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.

Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.

出版信息

Transpl Immunol. 2021 Aug;67:101413. doi: 10.1016/j.trim.2021.101413. Epub 2021 May 20.

Abstract

BACKGROUND

The impact of the reconstitution of IgG subclasses after allogeneic hematopoietic cell transplantation (allo-HCT) on the outcomes is unclear.

METHODS

We investigated the effects of stem cell source on the levels of serum IgG subclasses and their influence on the infection risk and prognosis. The levels of serum IgG, IgG2 and IgG4 were measured chronologically in 100 patients who underwent allo-HCT at our institute.

RESULTS

The median levels of serum IgG, IgA and IgM and the number of total B-cells were determined up to one year after allo-HCT. The serum IgG2 levels decreased within one year. A multiple linear regression analysis identified lymphoid malignancy, cord blood, and days after allo-HCT as significant risk factors for low serum IgG2 levels. There were no significant differences in the level of IgG or IgG2 at 90 days after allo-HCT between the late bacterial infection group (≥90 days following allo-HCT) and the control group (P = 0.34 and 0.45, respectively). There was no significant impact of the IgG, IgG2 or IgG4 levels on the survival or non-relapse mortality.

CONCLUSION

The results suggest that cord blood transplantation might affect humoral immune reconstitution, including the IgG2 level, after allo-HCT.

摘要

背景

异基因造血细胞移植(allo-HCT)后IgG亚类重建对预后的影响尚不清楚。

方法

我们研究了干细胞来源对血清IgG亚类水平的影响及其对感染风险和预后的影响。对我院100例行allo-HCT的患者按时间顺序检测血清IgG、IgG2和IgG4水平。

结果

在allo-HCT后长达一年的时间里测定了血清IgG、IgA和IgM的中位数水平以及总B细胞数量。血清IgG2水平在一年内下降。多元线性回归分析确定淋巴系统恶性肿瘤、脐血和allo-HCT后的天数是血清IgG2水平低的显著危险因素。在allo-HCT后90天,晚期细菌感染组(allo-HCT后≥90天)和对照组之间的IgG或IgG2水平无显著差异(P分别为0.34和0.45)。IgG、IgG2或IgG4水平对生存或无复发生存率无显著影响。

结论

结果表明,脐血移植可能会影响allo-HCT后包括IgG2水平在内的体液免疫重建。

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