异基因外周血造血干细胞移植后细胞免疫的重建

Immune Reconstitution after Allo-Peripheral Blood Hematopoietic Stem Cell Transplantation

目的 研究异基因外周血造血干细胞移植后细胞免疫的重建，探讨免疫治疗应用于造血干细胞移植后的残留病灶清除，并将其与化疗有机结合，以延长患者无病生存率的方法。方法 采用流式细胞仪，检测14例异基因外周血造血干细胞移植患者移植前后外周血中T、B、NK细胞的含量。结果 异基因外周血造血干细胞移植后1月内，患者血循环中CD3^＋细胞明显减少，至移植后3月逐渐恢复至正常；CD3^＋CD4^＋细胞移植后持续减少，至移植后6月甚至更长时间后才逐渐恢复；CD3^＋CD8^＋细胞于移植后1月内很快恢复。CD19^＋细胞于移植后l～3月降低，移植后3～6月逐渐恢复。NK细胞于移植后2月恢复，较T或B淋巴细胞恢复速度快。结论 异基因外周血造血干细胞移植后3月T细胞才逐渐恢复至正常水平；B细胞于移植后1～3月绝对及相对计数降低，移植后3～6月逐渐恢复；NK细胞于移植后2月恢复，较T或B淋巴细胞恢复速度快。

Objective To study the immune reconstitution after allo-peripheral blood hematopoietic stem cell transplantation（allo-PBSCT） , and to find the second category of immunotherapy which is effective in reducing the post-transplantation or postchemotheray residuals. Methods Peripheral blood of 14 patients with alIo-PBSCT was analyzed through the hospital clinical laboratory to measure the total white blood cell count. Lymphocyte subsets were enumerated by multiparameter flow cytometry for the first year after transplantation. Results After allo-PBSCT, the relative number of CD3^＋ cells, which was significantly decreased during the first month after transplantation, returned to the normal level within 3 months. During the initial months following alIo-PBSCT, the number of CD3^＋ CD4^＋ lymphocytes was decreased, but returned to the normal level 6 months later. While the number of CD3 ^＋ CD8^＋ lymphocytes returned to the normal level by 1 month after transplantation. The relative and absolute numbers of circulating cells expressing CD19 and CD20, two markers of mature B cells, were decreased during the first 3 months following transplantation and increased to a plateau from the third to the sixth month. NK cells were recovered within 2 months after grafting, which was quicker than T and B cells. Conclusion After allo-PBSCT, the relative number of CD3^＋ cells would return to a normal level within 3 months. The numbers of B cells could reach a plateau in 3 to 6 months. Recovery of NK cells might be within 2 months after grafting, which is quicker than T and B cells.