儿童再生障碍性贫血异基因造血干细胞移植术后免疫重建的临床研究

doi:10.3969/j.issn.1006-6233.2022.01.031

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Abstract Objective: To study the immunological reconstruction of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with aplastic anemia (AA) and the relationship with the acute graft-versus-host disease (aGVHD). Methods: From December 2017 to December 2019, 34 patients with AA underwent allo HSCT in the blood stem cell transplantation center of children's Hospital of the First Affiliated Hospital of Zhengzhou University. The lymphocyte subsets of 34 AA children in 1st, 3rd, 6th and 12th month after transplantation were analyzed retrospectively, and 15 healthy children were taken as reference. At the same time, the proportion of lymphocyte subsets between the group without aGVHD and the group with aGVHD was compared. Results: The proportion of CD3⁺ cells and CD8⁺ cells in the 1st, 3rd, 6th and 12th month after hematopoietic stem cell transplantation were higher than those in the healthy control group (P<0.05), showing a gradual downward trend. The percentage of CD4⁺ cells and the ratio of CD4⁺/CD8⁺ in the 1st, 3rd, 6th and 12th month after transplantation were lower than those in the healthy control group (P<0.05). The proportion of B cells in the 1st, 3rd, 6th month after transplantation was lower than that in the healthy control group, the difference was statistically significant (P<0.05), showing a gradual upward trend, and there was no significant difference between the two groups at the 12th month (P>0.05). The percentage of NK cells in the 1st month after transplantation was significantly higher than that in the healthy control group (P<0.05), but there was no significant difference between the two groups (P>0.05). The proportion of CD3⁺ cells and CD8⁺ cells in the non aGVHD group was lower than that in the aGVHD group in the 1st, 3rd months, and the proportion of NK cells was higher (P<0.05). The ratio of CD4⁺ cells, CD4⁺/CD8⁺ and B cells between the two groups had no significant difference in the 1st, 3rd month (P>0.05). Conclusion: CD3⁺ cells, CD8⁺ cells and NK cells are the main immune reconstitution after hematopoietic stem cell transplantation in children with aplastic anemia. AGVHD is easy to occur in children with higher proportion of CD8⁺ cells and low proportion of NK cells.

Key words： Immune reconstruction Aplastic anemia Allogeneic hematopoietic stem cell transplantation Child

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.01.031 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I1/151

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