慢性髓细胞白血病异基因外周血联合骨髓造血干细胞移植T淋巴细胞重建研究

 目的 观察慢性髓细胞白血病（CML）患者进行异基因外周血联合骨髓造血干细胞移植（allo-PBSCT+BMT）后T淋巴细胞的重建情况。方法 11例采用同胞异基因HLA6／6位点相合的allo-PBSCT+BMT的CML患者，监测移植后1年内血常规中淋巴细胞的总数和比例变化，并使用流式细胞术检测CD+3 T细胞、CD+4 T细胞、CD+8 T细胞在淋巴细胞中所占的比例及CD4／CD8比值的变化。结果 allo-PBSCT+BMT后淋巴细胞重建较快，在+60天淋巴细胞绝对值及比例就达到正常水平。早期T淋巴细胞以CD+8 T细胞为主导，在+60天达高峰，占淋巴细胞的（56.3±18.69）％，后逐渐降低。移植后1年CD+4 T细胞一直明显低于正常，导致CD4／CD8比值在移植后一年持续倒置，但比例逐渐向正常水平发展，到一年时CD4／CD8比值为0.79±0.38。结论 allo-PBSCT+BMT后T淋巴细胞重建及造血重建较快，同时不增加复发率和急慢性GVHD，是一种安全有效的移植方法。

The studies of T cells reconstitution in patients with chronic myegenous leukemia following allogenetic peripheral blood stem cell combined with bone marrow transplantation

Objective To observe the T cells reconstitution after allogenetic peripheral blood stem cell combined with bone marrow transplantation (allo-PBSCT+BMT) of chronic myegenous leukemia(CML) patients. Methods We used blood routine to detect the absolute number and proportion of lymphocytes and flow cytometer to measure CD+3 T cells, CD+4 T cells, CD+8 T cells and the CD4/CD8 ratio of 11 patients with CML following HLA 6/6 coincidence allo-PBSCT+BMT for one year. Results Lymphocytes reconstitution was fast after allo-PBSCT+BMT and the absolute number and proportion of lymphocytes achieved peak at +60 d. Among it, CD+8 T cell was the most of the lymphoid subsets and it also achieved peak at +60 d which was （56.3±18.69）％ of lymphocytes. CD+4 T cell was obviously less than normal in one year after allo-PBSCT+BMT which lead to a long time inversion ratio of CD4/CD8, but it had the tendency to become normal gradual－ly. Conclusion T cells reconstitution and hematopoiesis reconstitution after allo-PBSCT+BMT is fast, and the incidence of relapse, aGVHD and cGVHD don't increase in this transplant mode. allo-PBSCT+BMT is a safe and effective transplant mode.