Hrabánek J, Lukásová M, Chudomel V, Smetana K
Ustav hematologie a krevní transfuze, Praha.
Cas Lek Cesk. 1994 Jan 31;133(3):80-2.
After bone marrow transplantation serious complications develop which may limit the success of this therapeutic method. One of the early complications is an acute graft versus host reaction. The objective of the investigation was to evaluate the relationship between the number of active lymphocytes in the patient's blood stream after bone marrow transplantation and the development of an acute graft versus host reaction or rejection of the graft, and thus contribute towards prediction or diagnosis of these complications.
In 14 patients with acute myeloid leukaemia (3), acute lymphatic leukaemia (1), chronic myeloid leukaemia (6), myelodysplastic syndrome (2) and aplastic anaemia (2) bone marrow was transplanted: the donor was in all instances a HLA identical sibling. However, only 11 patients were evaluated. In the latter changes in the number of circulating active lymphocytes were assessed: their activity was evaluated from nucleolar characteristics expressed by RNA synthesis. Their values at the time of the acute graft versus host reaction (GVHD) varied between 7.4% and 17.3%; at the time when these patients were free from complications they were 2.2%-6.0% (the difference is at the borderline of significance). In 8 patients the rise of active lymphocytes preceded the manifestation of the graft versus host reaction by 3-7 days. At the time of infectious complications after bone marrow transplantation (temperatures of obscure origin, herpetic infections, varicella, adenoviral infections) the number of active lymphocytes did not increase (2.0%-10.0%), as compared with 3.4%-9.5% in the group without complications.
The increased percentage of activated lymphocytes in the peripheral blood stream of patients with an acute graft versus host reaction (GVHD) after bone marrow transplantation results from specific immunological procedures. Their assessment could help with the differential diagnostic difficulties frequently associated with the diagnosis of the acute graft versus host reaction.
骨髓移植后会出现严重并发症，这可能会限制这种治疗方法的成功率。早期并发症之一是急性移植物抗宿主反应。本研究的目的是评估骨髓移植后患者血流中活性淋巴细胞数量与急性移植物抗宿主反应或移植物排斥反应发生之间的关系，从而有助于对这些并发症进行预测或诊断。
对14例急性髓系白血病（3例）、急性淋巴细胞白血病（1例）、慢性髓系白血病（6例）、骨髓增生异常综合征（2例）和再生障碍性贫血（2例）患者进行了骨髓移植：所有病例的供体均为 HLA 相同的同胞。然而，仅对11例患者进行了评估。在后者中，评估了循环活性淋巴细胞数量的变化：通过RNA合成所表达的核仁特征来评估其活性。急性移植物抗宿主反应（GVHD）时其值在7.4%至17.3%之间变化；在这些患者无并发症时，其值为2.2% - 6.0%（差异接近显著水平）。8例患者活性淋巴细胞数量增加比移植物抗宿主反应的表现提前3 - 7天。骨髓移植后发生感染并发症（不明原因发热、疱疹感染、水痘、腺病毒感染）时，活性淋巴细胞数量未增加（2.0% - 10.0%），而无并发症组为3.4% - 9.5%。
骨髓移植后发生急性移植物抗宿主反应（GVHD）的患者外周血流中活化淋巴细胞百分比增加是由特定免疫程序导致的。对其进行评估有助于解决急性移植物抗宿主反应诊断中经常出现的鉴别诊断困难。
