T淋巴细胞亚群异常与淋巴瘤自体造血干细胞移植预后转归的相关性研究

Correlation between abnormity of T cell subsets and outcome of autologous hematopoietic stem cell transplantation in patients with lymphoma

目的 :探讨淋巴瘤患者T淋巴细胞亚群异常对自体造血干细胞移植预后的影响。方法 :收集2016年1月—2017年12月接受自体造血干细胞移植的55例淋巴瘤患者的临床资料,回顾性分析T淋巴细胞亚群异常与自体造血干细胞移植转归的相关性,评价T淋巴细胞亚群异常对患者预后的影响。结果 :淋巴瘤患者的年龄与CD3+细胞百分率升高、CD3+CD16+CD56+细胞百分率升高以及CD19+细胞百分率降低均具有相关性(P值均<0.05),而男性与CD3+CD4+细胞百分率升高和CD3-CD16+CD56+细胞百分率降低具有相关性(P值均<0.05)。T淋巴细胞亚群异常与自体造血干细胞移植前完全缓解状态无相关性(P> 0.05)。复发难治性淋巴瘤和CD3-CD16+CD56+细胞百分率降低是移植后淋巴瘤复发进展的危险因素(P值均<0.05)。根据危险因素的个数进行分层,具有0、1和2个危险因素的患者在移植后出现复发进展的比例分别为10.0%、32.3%和100.0%,差异具有统计学意义(P=0.001)。结论 :T淋巴细胞亚群异常可能是影响淋巴瘤患者自体造血干细胞移植预后的不良因素。

Objective: To analyze the effect of abnormal T cell subsets on the prognosis of patients with lymphoma after autologous hematopoietic stem cell transplantation(AHSCT).Methods: The clinical data of 55 patients with lymphoma who received AHSCT from January 2016 to December 2017 were collected. The correlation of abnormal T cell subsets with the outcome of AHSCT was analyzed retrospectively, and the effect of abnormal T cell subsets on the prognosis of patients after AHSCT was evaluated.Results: The age of lymphoma patients was correlated with the increased percentages of CD3^+ cells and CD3^+CD16^+CD56^+ cells and the decreased percentage of CD19^+ cells(all P<0.05), while the increased percentages of CD3^+CD4^+ cells and CD3^-CD16^+CD56^+ cells were found in the male patients with lymphoma(both P<0.05). Abnormity of T cell subsets was not correlated with the complete remission before AHSCT(P>0.05). Relapsed/refractory lymphomas and the decreased percentage of CD3^-CD16^+CD56^+ cells were identified as independent risk factors for the progression/relapse of tumor after AHSCT(both P<0.05). Based on the stratification by these two factors, the incidence of progression/relapse after AHSCT was 10.0%, 32.3% or 100.0% in the patients without risk factor, with 1 or 2 risk factors, respectively(P=0.001).Conclusion: The abnormal T cell subsets may be a poor prognostic factor for the patients with lymphoma received AHSCT.