同胞供者全相合脐血移植治疗重型β地中海贫血的细胞免疫重建分析

The analysis of cell immune reconstitution after sibling-matched umbilical cord blood transplantation in patients with severe β-thalassemia

目的：探讨同胞供者全相合脐血移植治疗重型β地中海贫血后免疫重建的特点。方法：8例同胞供者HLA全相合脐血移植成功治疗重型β地中海贫血患者,采用流式细胞仪分别在移植后1、3、6、12个月检测T细胞亚群。结果：该组患者植入证据显示均移植成功,在移植后4周内恢复造血重建;3例发生Ⅰ-Ⅱ急性移植物抗宿主病,无慢性移植物抗宿主病发生;移植后CD3＋细胞1个月为（45.3±27.2）%,3个月为（66.7±10.4）%,6个月为（68.7±14.5）%,12个月为（71.7±10.2）%;移植后CD4＋细胞1个月为（13.3±7.8）%,3个月为（21.8±11.6）%,6个月为（19.4±10.9）%,12个月为（30.1±10.4）%;移植后CD8＋细胞1个月为（32.1±15.4）%,3个月为（30.6±10.9）%,6个月为（26.9±7.3）%,12个月为（28.1±5.6）%;移植后CD3-CD19＋细胞1个月为（6.4±5.6）%,3个月为（12.7±3.4）%,6个月为（16.3±7.3）%,12个月为（16.7±5.7）%;移植后CD3-CD16＋CD56＋细胞1个月为（16.4±7.4）%,3个月为（15.9±7.6）%,6个月为（14.7±6.6）%,12个月为（15.6±3.4）%。结论：同胞供者HLA全相合脐血移植治疗重型β地中海贫血后1个月CD8＋细胞逐渐恢复正常,移植后3个月时CD3＋细胞和NK细胞逐渐恢复正常水平,移植后6个月后CD4＋和CD19＋细胞表达水平逐渐恢复达正常水平。

Objective：To investigate the characteristics of immune reconstitution after umbilical cord blood transplantation （UCBT） in patients with severe β-thalassemia.Methods：Eight severe β-thalassemia patients received HLA-identical sibling UCBT and lymphocyte subsets of each patients were examined using flow cytometry at 1,3,6 and 12 months after the transplantation.Results：Within 4 weeks following successful UCBT,haematopoiesis recovered in all patients without acute or chronic GVHD.At months 1,3,6 and 12 posttransplant,CD3＋ cells reached a mean value of （45.3±27.2）%,（66.7±10.4）%,（68.7±14.5）% and （71.7±10.2）%,CD4＋ cells reached （13.3±7.8）%,（21.8±11.6）%,（19.4±10.9）% and （30.1±10.4）%,CD8＋ cells reached （32.1±15.4）%,（30.6±10.9）%,（26.9±7.3）% and （28.1±5.6）%,CD3-CD19＋cells reached （6.4±5.6）%,（12.7±3.4）%,（16.3±7.3）% and （16.7±5.7）% and CD3-CD16＋CD56＋ cells reached （16.4±7.4）%,（15.9±7.6）%,（14.7±6.6）% and （15.6±3.4）%,respectively.Conclusion：For severe β-thalassemia patients undergoing UCBT,CD8＋ cells,CD3＋ cells as well as NK cells,and CD4＋ cells as well as CD19＋ cells recover to normal values gradually at months 1,3 and 6 month postgraft,respectively.