Lin Zhi, Shen Jie, Fu Yicheng, Liu Jiao, Yan Lu, Li Xin, Yang Minghua
Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Hunan Clinical Research Center of Pediatric Cancer, Changsha, China.
Front Immunol. 2025 Sep 2;16:1624168. doi: 10.3389/fimmu.2025.1624168. eCollection 2025.
While dyslipidemia is established as a key modulator of innate and adaptive immune responses, its role in hematopoietic reconstitution remains unclear. This study aimed to characterize lipid profiles in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) and evaluate the associations between dyslipidemia and clinical outcomes.
A retrospective analysis was conducted in a cohort of 106 adult patients (≥18 years) who underwent allogeneic HSCT between January 2019 and December 2023 and had complete lipid records.
Profound dyslipidemia was observed post-transplantation, with over 60% of patients developing significantly decreased high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) compared to baseline. HDL-C reached its nadir around day 14 and recovered slowly thereafter. Patients with grade III-IV acute graft-versus-host disease (GVHD) exhibited significantly lower HDL-C levels compared to those without GVHD. Lower HDL-C levels were correlated with delayed neutrophil engraftment and inferior GVHD-free/relapse-free survival (GRFS), though not with overall survival (OS). An HDL-C threshold of ≤0.84 mmol/L was identified as an independent predictor of GVHD.
Early post-transplant HDL-C dynamics represent a promising biomarker for GVHD risk stratification. These findings support the incorporation of protocolized lipid monitoring into HSCT management to guide preemptive therapeutic interventions.
虽然血脂异常已被确认为先天性和适应性免疫反应的关键调节因子，但其在造血重建中的作用仍不清楚。本研究旨在描述接受异基因造血干细胞移植（HSCT）患者的血脂谱，并评估血脂异常与临床结局之间的关联。
对2019年1月至2023年12月期间接受异基因HSCT且有完整血脂记录的106例成年患者（≥18岁）进行回顾性分析。
移植后观察到严重的血脂异常，超过60%的患者与基线相比出现高密度脂蛋白胆固醇（HDL-C）显著降低以及甘油三酯（TG）、总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）升高。HDL-C在第14天左右降至最低点，此后缓慢恢复。与无III-IV级急性移植物抗宿主病（GVHD）的患者相比，患有III-IV级急性GVHD的患者HDL-C水平显著更低。较低的HDL-C水平与中性粒细胞植入延迟和较差的无GVHD/无复发生存期（GRFS）相关，但与总生存期（OS）无关。HDL-C阈值≤0.84 mmol/L被确定为GVHD的独立预测因子。
移植后早期HDL-C动态变化是GVHD风险分层的一个有前景的生物标志物。这些发现支持将标准化血脂监测纳入HSCT管理，以指导预防性治疗干预。
