The study of immune reconstitution after human leukocyte antigen-matched allogenetic hematopoietic stem cell transplantation

doi:10.3969/j.issn.1673-8640.2014.09.013

Abstract

Abstract: Objective To investigate the immune reconstitution after human leukocyte antigen (HLA)-matched allogenetic hematopoietic stem cell transplantation (allo-HSCT). Methods A total of 42 patients undergoing allo-HSCT from 2009 to 2013 in the Blood and Marrow Transplantation Center, Department of Hematology, Ruijin Hospital were enrolled in this study. The immunoglobulin levels of IgG, IgA, IgM and IgE prior to preconditioning and at 1, 3, 6, 12 and 24 months after transplantation were determined by rate nephelometry. T lymphocytes (CD3⁺, CD3⁺CD4⁺ and CD3⁺CD8⁺), B cell (CD19⁺) and natural killer (NK) cell (CD56⁺CD16⁺) levels were determined by flow cytometry(FCM) prior to preconditioning, at the day of transplantation, 14 and 21 d, 1, 3, 6, 12, 18 and 24 months after transplantation. The recovery of immunoglobulin and lymphocyte subsets was analyzed, and the impacts of pre-and post-transplantation variables were evaluated. Results The levels of CD3⁺ and CD3⁺CD8⁺ returned to be normal at 14 d after transplantation, while the recovery of CD3⁺CD4⁺ was slow, and its level remained lower than or closer to be normal in 2 years after transplantation. CD56⁺CD16⁺ recovered rapidly and returned to be normal at approximately 21 d after transplantation. CD19⁺ were back to be normal at 6 months after transplantation, and the recovery times of IgM, IgG and IgA were 1, 3 and 6 months, respectively. No significant differences were found in the immune reconstitution between male and female patients. The immune reconstitution of sibling donor transplantation was faster than that of unrelated donor transplantation. The levels of CD3⁺CD8⁺ at early stage of post-transplantation were significantly higher in patients with severe infection and Ⅲ-Ⅳ graft-versus-host disease (GVHD) than those in patients without infection and GVHD. For patients with Ⅲ-Ⅳ GVHD, CD3⁺ was significantly higher than that for patients without GVHD at early stage of post-transplantation, while the recovery of CD3⁺CD4⁺ tended to be slow. Conclusions The lymphocyte subsets recover after allo-HSCT in the following order: CD56⁺CD16⁺, CD3⁺CD8⁺, CD19⁺ and CD3⁺CD4⁺. HLA matching benefits the immune reconstitution. The application of anti-thymocyte globulin and GVHD occurrence after transplantation are the most important factors influencing the immune reconstitution.

Key words: Immune reconstitution, Allogenetic hematopoietic stem cell transplantation, Lymphocyte

CLC Number:

R446.61

WEI Beiwen, TANG Wei, PENG Yibing, HU Jiong. The study of immune reconstitution after human leukocyte antigen-matched allogenetic hematopoietic stem cell transplantation[J]. , 2014, 29(9): 925-930.

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