单倍体相合骨髓移植后CD4^+CD25^+ T细胞免疫恢复的临床研究

Clinical Research on Reconstitution of CD4^+CD25^+ T Cells after Haploidentical Bone Marrow Transplantation

本研究探讨单倍体相合骨髓移植后CD4+CD25+T细胞免疫恢复及其与移植物抗宿主病(GVHD)和复发的关系。采集27例单倍体相合骨髓移植患者在移植后不同时间内的外周血标本,用流式细胞仪检测分析CD4+CD25+T细胞百分比和绝对数,同时比较该细胞亚群恢复与GVHD和白血病复发的关系。结果表明:经过G-CSF动员后供者外周血中CD4+CD25+细胞百分比明显增高(p<0.05)。移植后30天CD4+CD25+细胞恢复到正常水平的20%,但在移植后3个月内恢复颇为缓慢,直到180天才恢复到正常水平的50%。CD4+CD25+细胞恢复与急性GVHD的发生无关,但是在慢性GVHD组CD4+CD25+显著增高。移植后1年内未发现复发与CD4+CD25+细胞绝对计数有关。结论:在骨髓移植后给予抗CD25抗体预防GVHD的治疗模式下,CD4+CD25+细胞恢复与急性GVHD的发生无关,但与慢性GVHD的发生似乎有关,而与白血病的复发的关系不明确。

The aim of this study was to investigate the reconstitution of CD4^＋CD25^＋T cells after haplo-identical bone marrow transplantation （hiBMT） and its correlation with graft versus host disease （GVHD） and relapse. Peripheral blood samples from 27 patients after hiBMT were harvested and the percentage and absolute counts of CD4^＋CD25^＋T cells were detected by flow cytometry. The correlations of GVHD occurance and diseare relapse with the reconstitution Of CD4^＋CD25^＋T cells were analyzed. The results showed that the percentage of CD4^＋CD25^＋T cells of peripheral blood samples increased significantly after G-CSF priming. At day 30 after hiBMT, CD4^＋CD25^＋T cells were recovered to the 20% of normal level, followed by a slowly process in 3 months, and up to one half of the normal level at 180 days. There was no evidence to prove relationship between CD4^＋CD25^＋T cells and acute GVHD, while CD4^＋CD25^＋T cells were increased significantly in the chronic GVHD group. The absolute count of CD4^＋CD25^＋T cells showed no relations with relapse of leukemia during the first year after hiBMT. In conclusions, chronic but not acute GVHD was in relation to the reconstitution of CD4^＋CD25^＋T cells based on the anti-CD25 antibody therapy model for the prevention of GVHD after hiBMT. Further investigation is needed to clarify whether the relapse of leukemia after hiBMT is related to the reconstitution of CD4^＋CD25^＋T cells.