异基因干细胞移植后T细胞重建及与慢性移植物抗宿主病关系的研究

目的:探讨恶性血液病异基因干细胞移植后T细胞免疫重建的特点及与慢性移植物抗宿主病(cGVHD)的关系.方法:采用流式细胞仪动态检测42例恶性血液病患者异基因干细胞移植前、后不同时期T淋巴细胞亚群的变化,并对其中18例白血病患者检测其移植前、后不同时期的CD3 CD5 、CD3 CD45RA 、CD4 CD45RA 细胞的变化情况.结果:42例患者均重建造血.移植后CD4 T细胞恢复较慢,而CD8 T细胞则恢复较快,导致CD4 /CD8 细胞比值在移植后1年内持续倒置.回输CD 34细胞数量分别与移植后30 d时的CD3 、CD4 、CD8 T细胞数呈正相关.cGVHD组患者的CD3 CD45RA 、CD4 CD45RA 细胞均明显低于无GVHD组患者(均P<0.05).结论:异基因干细胞移植后CD4 T细胞恢复慢,而CD8 T细胞恢复较快.回输CD 34细胞数与移植后早期患者T细胞重建的快慢密切相关.cGVHD可引起初始T细胞亚群(CD45RA 细胞)减少.

A STUDY ON THE RECONSTITUTION OF T CELL AND ITS RELATION WITH CHRONIC GRAFT-VERSUS-HOST DISEASE AFTER ALLOGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION

Objective:To study the reconstitution of T cell mediated immunity and its relation with chronic graft-versus-host disease(cGVHD) after allogeneic peripheral blood stem cell transplantation(Allo-PBSCT) in hematologic manlignancies.Methods:Flow cytometry was used to continuously detect the concentration of T lymphocyte subsets including CD_3~+,CD_4~+,CD_8~+ T~()cells in peripheral blood of 42 cases with hematologic malignancies after Allo-PBSCT.Furthermore,CD_3~+CD_5~+,CD_3~+CD_(45)RA~(+) and CD_4~+CD_(45)RA~(+)T cells were continuously measured in 18 patients with leukemia after Allo-PBSCT.Result:All patients were successfully engrafted.Post-transplant recovery of CD_4~+ T cells was delayed while that of CD_8~+ T cells recovered rapidly,which leads to the reversal of CD_(4)/CD_(8) ratio within 1 year after transplantation.There was a significantly positive correlation between infused CD_(34)~+ cells and CD_3~+,CD_4~+,CD_8~+T cells on day 30 after transplantation,respectively.The number of CD_3~+CD_(45)RA~(+) and CD_4~+CD_(45)RA~(+) T cells were lower in cGVHD positive group than that in cGVHD negative group(P<0.05).Conclusion:These results demonstrate that the recovery of CD_4~+ T cells was delayed while CD_8~+ T cells recovered rapidly.The number of infused CD_(34)~+ cells was closely correlated with T cells rapidly reconstitution in early post transplantation.cGVHD can reduce the number of na ve T cells.