移植后早期免疫重建与急性移植物抗宿主病关系的研究

Study on Relation of Early Immune Reconstitution with Acute Graft-Versus-Host Disease

为了分析异基因造血干细胞移植 (allo HSCT)后的早期淋巴细胞重建与急性移植物抗宿主病 (aGVHD)之间的关系 ,本研究对 2 6例恶性血液病患者行allo HSCT ,移植后 2个月内采用流式细胞术动态检测淋巴细胞亚群CD3+ ,CD4 + ,CD8+ ,CD2 5 + ,CD6 9+ 细胞的变化。所有患者均获得造血重建 ,9例发生Ⅰ度GVHD ,5例发生Ⅱ -Ⅳ度GVHD。CD2 5 + 细胞在aGVHD发生组于移植后第 2周上升 ,第 3周达峰值 ,早于aGVHD的症状出现 ,与疾病的严重程度显著相关 ,随症状的缓解而下降。实验结果提示 :分析患者移植后的早期免疫重建可以预测aGVHD的发生 ,CD2 5 + 细胞在aGVHD发生之前明显上升 ,是预测aGVHD的指标。

To analyze the relation of early immune reconstitution with acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation(all-HSCT), the changes of CD3 +, CD4 +, CD8 +, CD25 + and CD69 + cells in peripheral blood from 26 patients with hematologic malignancies were assayed by flow cytometry within 2 months after allo-HSCT. All patients achieved hematopoietic reconstitution, and grade Ⅰ and Ⅱ-Ⅳ GVHD were developed in 9 and 5 patients, respectively. CD25 + cells were increased in patients aGVHD at week 2 after transplantation and the peak value was appeared at week 3. The increase of CD25 + cells was preceded the occurence of clinical signs of aGVHD. The maximal levels of CD25 + cells increase correlated significantly with the severity of aGVHD. The increase of CD25 + cells was declined along with remission of aGVHD signs. Our results suggest that analyzing immune reconstitution after allo-HSCT could predict occurence of aGVHD, and CD25 + cell increase prior occurence of aGVHD is predictive marker for aGVHD.