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来自供体的过继性免疫转移为异基因造血干细胞移植后乙肝表面抗体阴性的患者提供了抗乙肝病毒保护。

Adoptive immune transfer from donors offers Anti-HBV protection to HBsAb-negative patients after Allo-HSCT.

作者信息

Ren Jinhua, Lin QiaoXian, Chen Qi, Xu Jingjing, Chen Dabin, Chen Renli, Lin Kangni, Zhu Haojie, Ye Chenjing, Luo Xiaofeng, Chen Shaozhen, Kong Hui, Lin Qiong, Li Nan, Lin Xu, Chen Zhizhe, Hu Jianda, Yang Ting

机构信息

Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 29 Xinquan Road, 350001, Fuzhou, Fujian, P. R. China.

Department of Hematology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fuzhou, Fujian, P. R. China.

出版信息

iScience. 2023 Feb 28;26(3):106290. doi: 10.1016/j.isci.2023.106290. eCollection 2023 Mar 17.

DOI:10.1016/j.isci.2023.106290
PMID:36936790
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10014299/
Abstract

Adoptive transfer of hepatitis B virus (HBV) immunity may occur following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Here, we investigated the adoptive transfer of HBV immunity in 112 patients without HBV surface antibody (HBsAb) (HBsAb-) at the time of their first allo-HSCT. After allo-HSCT, HBV-DNA(87.5%) and HBsAg(11.1%%)cleared in HBsAg+ patients. All HBsAg- patients acquired HBsAb immediately. Nevertheless, HBsAb titers subsequently declined, and 39/67 (58.2%) patients lost HBsAb during follow-up. The 5-year overall survival (OS) was better in patients who lost HBsAb. Multivariate analysis showed that the independent risk factors for OS were lack of cytomegalovirus (CMV) clearance, acute graft-versus-host disease (aGVHD), and no HBsAb loss. Overall, adoptive immune transfer offers anti-HBV protection to patients without HBsAb, as they acquire HBsAb and clear HBV-DNA and HBsAg, while HBsAb loss after allo-HSCT predicts better survival.

摘要

同种异体造血干细胞移植(allo-HSCT)后可能会发生乙型肝炎病毒(HBV)免疫力的过继转移。在此,我们调查了112例首次allo-HSCT时无HBV表面抗体(HBsAb)(HBsAb-)患者的HBV免疫力过继转移情况。allo-HSCT后,HBsAg阳性患者的HBV-DNA(87.5%)和HBsAg(11.1%)清除。所有HBsAg阴性患者立即获得了HBsAb。然而,HBsAb滴度随后下降,39/67(58.2%)的患者在随访期间失去了HBsAb。失去HBsAb的患者5年总生存率(OS)更好。多因素分析显示,OS的独立危险因素是巨细胞病毒(CMV)未清除、急性移植物抗宿主病(aGVHD)和未失去HBsAb。总体而言,过继免疫转移为无HBsAb的患者提供了抗HBV保护,因为他们获得了HBsAb并清除了HBV-DNA和HBsAg,而allo-HSCT后HBsAb的丧失预示着更好的生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/d56a4fc1451c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/44adb3dfc0ef/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/a4f711c4e01c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/96e883dbaba9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/f39ea7b0855a/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/d56a4fc1451c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/44adb3dfc0ef/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/a4f711c4e01c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/96e883dbaba9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/f39ea7b0855a/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00d/10014299/d56a4fc1451c/gr4.jpg

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本文引用的文献

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Effectiveness of prophylactic antiviral therapy in reducing HBV reactivation for HBsAg-positive recipients following allogeneic hematopoietic stem cell transplantation: a multi-institutional experience from an HBV endemic area.预防抗病毒治疗在降低 HBV 再激活中的有效性:来自 HBV 流行地区的多机构经验,用于 HBsAg 阳性受者异基因造血干细胞移植后。
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Hepatitis B Virus Infection in Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation.接受异基因造血干细胞移植患者的乙型肝炎病毒感染
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Hepatitis B Seropositive Status in Recipients or Donors Is Not Related to Worse Outcomes after Haploidentical Hematopoietic Stem Cell Transplantation.在单倍体造血干细胞移植后,受者或供者的乙型肝炎表面抗原阳性状态与较差的结局无关。
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