Abstract:

Objective To investigate the immune reconstitution of CD4⁺ T cells after allogeneic hematopoietic stem cell transplantation（allo-HSCT） and its correlation with invasive fungal infection（IFI） in patients with hematological malignancy. Methods A total of 47 patients with hematological malignancy and undergoing allo-HSCT in Binzhou Medical University Hospital from February 2010 to October 2014 were enrolled. A total of 40 healthy subjects were enrolled as control group. After transplantation for 1,2 and 3 months,the count of immune subpopulation and concentration of cytokines were determined by flow cytometry and enzyme-linked immunosorbent assay（ELISA）,respectively. The incidence of IFI after transplantation and its correlation with immune reconstitution of CD4⁺ T cells were observed. Results The counts of CD4⁺ T cells and immune subpopulation increased progressively after transplantation,and the immune subpopulation count after transplantation for 3 months was lower than that in control group. Compared with control group,the levels of interleukin（IL）-6 and IL-10 after transplantation increased,while that of transforming growth factor（TGF）-β decreased. The incidence rate of IFI was 19.15%（9/47）. Multivariate Logistic regression analysis showed that IFI might be related to helper T cell（Th）17 cell count instead of Th1,Th2 and regulatory T cell counts as well as IL-6,IL-10,TGF-β and interferon（IFN）-γ levels. Conclusions After allo-HSCT,the immune reconstitution of CD4⁺ T cells delays,and Th17 cell count decreases obviously,which may be related to the occurrence of IFI.

Key words: Allogeneic hematopoietic stem cell transplantation, Immune reconstitution, Invasive fungal infection, Cytokine