外周血干细胞移植与非血缘脐带血移植的患者免疫重建规律的比较  

Comparison of immune reconstitution after peripheral blood stem cell transplantation and umbilical cord blood transplantation

作　　者：黄盼盼 张爱梅 张翠萍 毛菊 朱小玉 刘会兰 孙自敏 祝怀平 Huang Panpan;Zhang Aimei;Zhang Cuiping;Mao Ju;Zhu Xiaoyu;Liu Huilan;Sun Zimin;Zhu Huaiping(The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)检验科,合肥230001

出　　处：《中华检验医学杂志》2021年第12期1138-1144,共7页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(31870897);中央高校基本科研业务费专项资助基金(WK9110000001);安徽省重点研究与开发计划项目(1804h08020245)。

摘　　要：目的观察外周血干细胞移植与非血缘脐带血移植术后免疫重建差异。方法将2018年1月至2020年3月期间在中国科学技术大学附属第一医院恶性血液疾病并接受异基因造血干细胞移植患者共300例[年龄18(8,33)岁,男163例,女137例],其中行脐带血移植255例,外周血干细胞移植45例纳入此次研究。运用多色流式检测非血缘脐带血移植物、外周血干细胞移植物以及患者接受造血干细胞移植后外周血中淋巴细胞各类亚群,比较患者术前2种移植物差异以及这300例患者2种移植术后在第1、2、3、4、6、9、12、18个月的淋巴细胞亚群的比例和绝对计数,并且回顾性分析2种移植类型在18个月内无病生存患者的资料。结果移植物中外周血组NKT细胞相对计数高于脐带血组(2.79%>0.24%,P<0.001)。UCBT组辅助性T细胞的百分比高于PBSCT组(20.6%>16.6%,P<0.05),且自半年后绝对计数也高于PBSCT组(624个/μl>373个/μl,P<0.05)。UCBT组的NK1细胞百分比(第3~9个月)和绝对计数(第4~12个月)明显高于PBSCT组(1.7%>0.9%,30个/μl>16个/μl,P<0.05)。NKT细胞在整个监测过程中UCBT组均低于PBSCT组(相对比例和绝对计数)(0.7%<3.3%,4个/μl<28个/μl,P≤0.001)。UCBT组的DNT细胞比例(1年内)和绝对计数(半年内)明显低于PBSCT组(0.6%<5.9%,5个/μl<74个/μl,P<0.05)。结论非血缘脐带血移植患者术后的淋巴细胞重建较外周血干细胞移植组快,非血缘脐带血移植术后具有更强的免疫重建能力。Objective To explore the differences of immune reconstitution between peripheral blood stem cell transplantation and umbilical cord blood transplantation.Methods A total of 300 patients(aged 18(8,33),163 males and 137 females)with malignant hematological diseases who received allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to March 2020 were enrolled in this study,including 255 cases of umbilical cord blood transplantation and 45 cases of peripheral blood stem cell transplantation.Multicolor flow cytometry was applied to analyze lymphocyte subsets of the percentages and absolute counts in the two donor types and peripheral blood of patients after receiving hematopoietic stem cell transplantation.The differences between the two grafts were compared,and the lymphocyte subsets results were evaluated at 1,2,3,4,6,9,12,and 18 months after transplantation.18-month disease-free survival(DFS)within the 300 patients under the two transplantation types were retrospectively analyzed.Results 1.The proportion of NKT cells in peripheral blood group was significantly higher than that in cord blood group(2.79%vs 0.24%,P<0.001).2.The proportion of helper T cells in the UCBT group was higher than that in the PBSCT group,as well as the counts 6 months after transplantation(P<0.05).3.The proportion of NK1 cells(3rd to 9th month)and count(4th to 12th month)in UCBT group were significantly higher than those in PBSCT group(P<0.05).4.NKT cells in the UCBT group were lower than those in the PBSCT group(proportion and count)throughout the monitoring process(P≤0.001).5.The proportion of DNT cells(within 1 year)and count(within 6 months)in the UCBT group were significantly lower than those in the PBSCT group(P<0.05).Conclusions Compared with the peripheral blood stem cell transplantation group,the umbilical cord blood transplantation patients had a faster rate of lymphocyte reconstitution,and patients received umbilical cord blood transp

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分 类 号：R457.7[医药卫生—治疗学]