自体外周血造血干细胞移植后淋巴细胞亚群的恢复

Recovery of lymphocyte subsets after autologous peripheral blood stem cell transplantation

目的探讨自体外周血造血干细胞移植(auto-PBSCT)后免疫重建的规律。方法测定血液肿瘤患者auto-PBSCT前后淋巴细胞各亚群的绝对值。结果部分亚群在移植前低于正常。移植后各细胞亚群恢复时间不同,其中NK细胞在6个月恢复;B细胞在9个月恢复正常。T细胞总数在9个月恢复正常,其中主要为CD3+CD8+细胞。CD3+CD4+细胞在18个月恢复,而CD4+CD28+细胞在2年内仍未恢复。CD3+CD8+细胞在移植后早期有所下降,在3个月时恢复并高于正常,至9个月时逐渐下降至正常。CD3+CD8+细胞的主要部分是免疫表型呈活化的T细胞,即CD8+HLA-DR+细胞和CD8+CD38+细胞。两者分别在1个月和3个月时高于正常,在9个月时恢复正常。结论血液肿瘤患者移植前即存在淋巴细胞亚群异常的前提下,移植后NK细胞最先恢复,其次为B细胞,T细胞各亚群中CD3+CD8+细胞恢复较早,其中主要为活化T细胞。

Objective To evaluate the lymphocyte reconstitution after autologous peripheral blood stem cell transplantation （auto-PBSCT）. Methods We analyzed the lymphocyte subsets in patients who received autologous PBSCT for the hematological malignancies. Results Some groups of cell were under the normal level before the transplantation. When the lymphocyte recovering to normal after PBSCT, the NK cells recovered to normal in 6 months, the B ceils recovered to normal in 9 months. The T cells were below the normal up to 9 months after transplantation, among them were mainly the CD3^＋ CD8^＋ cells. The CD3^＋ CD4^＋ cells took 18 months to recover, with the CD43^＋ CD28^＋ cells being in low level up to 2 years pest-transplant. A high proportion of CD3 ^＋ CD8^ ＋ cells displayed a phenotype compatible with activated T cells （CD8^＋ HLA-DR^＋ , CD8^＋ CD38^＋ ）, while their numbers were even higher than the normal in 1 and 3 months after PBSCT respectively. Both of them returned to normal in 9 months after PBSCT. Conclusion In the pre-transplant abnormal lymphocyte subsets, NK ceils were the first group to recover, then followed B cells. The repopulation of CD3^ ＋ T cells were mainly attributed to the increasing of CD3^＋ CD8^＋~ cells, and most of them were activated T cells.