Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China.
Anhui Provincial Key Laboratory of Blood Research and Applications, Hefei, Anhui, 230001, China.
Chin Med J (Engl). 2024 May 20;137(10):1207-1217. doi: 10.1097/CM9.0000000000002807. Epub 2023 Aug 24.
With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation (UCBT), the correlation between immune reconstitution (IR) after UCBT and graft-versus-host disease (GVHD) has been reported successively, but reports on double-negative T (DNT) cell reconstitution and its association with acute GVHD (aGVHD) after UCBT are lacking.
A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology, the First Affiliated Hospital of USTC, between August 2018 and June 2021. IR differences were compared between the patients with and without aGVHD.
The absolute number of DNT cells in the healthy Chinese population was 109 (70-157)/μL, accounting for 5.82 (3.98-8.19)% of lymphocytes. DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation. Importantly, the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year ( F = 4.684, P = 0.039 and F = 5.583, P = 0.026, respectively). In addition, the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased, and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD (HR = 0.46, 95% confidence interval [CI]: 0.23-0.93; P = 0.031).
Compared to the number of DNT cells in Chinese healthy people, the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow. In addition, the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.
随着越来越多的血液系统恶性肿瘤患者接受脐带血移植（UCBT）治疗，UCBT 后免疫重建（IR）与移植物抗宿主病（GVHD）之间的相关性已相继报道，但有关 UCBT 后双阴性 T（DNT）细胞重建及其与急性 GVHD（aGVHD）之间的关系的报道较少。
对 2018 年 8 月至 2021 年 6 月在我院血液科接受单份 UCBT 作为首次移植的 131 例血液系统恶性肿瘤患者进行了一项基于人群的观察性研究。比较了发生和未发生 aGVHD 患者之间的 IR 差异。
健康中国人群 DNT 细胞的绝对值为 109（70-157）/μL，占淋巴细胞的 5.82（3.98-8.19）%。DNT 细胞恢复延迟，甚至在移植后 1 年仍未达到正常水平。重要的是，在 UCBT 患者中，无 aGVHD 组患者的 DNT 细胞绝对值和百分比在 1 年内均明显高于有 aGVHD 组（ F = 4.684，P = 0.039； F = 5.583，P = 0.026）。此外，移植后第一个月的 DNT 细胞数量与 aGVHD 的严重程度呈显著负相关，UCBT 后第一个月 DNT 细胞的快速重建是 aGVHD 的独立保护因素（HR = 0.46，95%置信区间[CI]：0.23-0.93；P = 0.031）。
与中国健康人群 DNT 细胞数量相比，UCBT 后血液系统恶性肿瘤成人的 DNT 细胞重建缓慢。此外，移植后早期 DNT 细胞的快速重建与 aGVHD 的发生率较低有关。
