Yao Di, Tian Yuan-Yuan, Lu Jun, Xiao Pei-Fang, Ling Jing, Zheng De-Fei, Gao Jing, Fan Li-Yan, Zheng Jia-Jia, Li Jie, Hu Shao-Yan
Department of Hematology, Children's Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China.
Department of Hematology, Children's Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Aug;31(4):1184-1191. doi: 10.19746/j.cnki.issn.1009-2137.2023.04.039.
To investigate the correlation between plasmacytoid dendritic cell (pDC) dose in grafts and the occurrence of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
The clinical data of 80 children who received allo-HSCT in Children's Hospital of Soochow University from August 20, 2020 to June 11, 2021 were retrospectively analyzed. Proportions of DC subsets and T-cell subsets in grafts were detected by flow cytometry in order to calculate infused cell dose of each cell. Weekly monitoring of CMV-DNA copies in peripheral blood for each child were performed after transplantation. The last follow-up date was December 31, 2021.
All the children gained hematopoietic reconstitution. CMV infection was observed in 51 children (63.8%±5.4%) within the first 100 days after transplantation, including 2 cases developing CMV disease. Univariate analysis indicated that infused doses of DC and pDC were significantly associated with CMV infection within 100 days after allo-HSCT ( <0.05). Multivariate analysis indicated that a high dose infusion of pDC was an independent protective factor for CMV infection within 100 days after allo-HSCT ( <0.05). By the end of follow-up, 7 children died of transplantation-related complications, including 2 deaths from CMV disease, 2 deaths from extensive chronic graft-versus-host disease, and 3 deaths from capillary leak syndrome. The overall survival rate was 91.2%.
The pDC in grafts may be associated with early infection of CMV after allo-HSCT, while a high infused pDC dose may serve as a protective factor for CMV infection after transplantation.
探讨异基因造血干细胞移植（allo-HSCT）后移植物中浆细胞样树突状细胞（pDC）剂量与巨细胞病毒（CMV）感染发生之间的相关性。
回顾性分析2020年8月20日至2021年6月11日在苏州大学附属儿童医院接受allo-HSCT的80例儿童的临床资料。采用流式细胞术检测移植物中DC亚群和T细胞亚群的比例，以计算每个细胞的输入细胞剂量。移植后每周对每个儿童外周血中的CMV-DNA拷贝数进行监测。最后随访日期为2021年12月31日。
所有儿童均获得造血重建。51例儿童（63.8%±5.4%）在移植后100天内发生CMV感染，其中2例发展为CMV病。单因素分析表明，DC和pDC的输入剂量与allo-HSCT后100天内的CMV感染显著相关（<0.05）。多因素分析表明，高剂量输注pDC是allo-HSCT后100天内CMV感染的独立保护因素（<0.05）。至随访结束时，7例儿童死于移植相关并发症，其中2例死于CMV病，2例死于广泛慢性移植物抗宿主病，3例死于毛细血管渗漏综合征。总生存率为91.2%。
移植物中的pDC可能与allo-HSCT后CMV的早期感染有关，而高剂量输注pDC可能是移植后CMV感染的保护因素。
