Journal of Clinical Pediatrics >
Clinical research on cellular immune reconstitution after allogeneic hematopoietic stem cell transplantation in children
Received date: 2021-09-29
Online published: 2022-05-13
Objective To investigate the clinical characteristics of immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. Methods Children with complete clinical data who received allo-HSCT in the department of hematology and oncology from July 2019 to October 2020 were selected as the study subjects. The absolute count of peripheral blood lymphocyte subsets (CD3+ T cells, CD4+ T cells, CD8+ T cells, CD16+ CD56+ NK cells, CD19+ B cells, CD4+ CD25+ Treg cells) was dynamically monitored on day 0, 14, 21, 28, 60 and 100 after transplantation. The children were divided into non-aGVHD group and aGVHD group according to the presence or absence of acute graft-versus-host disease (aGVHD), and the differences of lymphocyte subsets between the two groups were compared. Results A total of 75 children received allo-HSCT, and 42 of them with complete clinical data after 100 days of transplantation were included in this study. There were 20 boys and 22 girls with a median age of 5.4 (2.8~9.3) years. There were statistically significant differences in the levels of CD3+ T cells, CD4+ T cells, CD8+ T cells, CD16+ CD56+ NK cells, CD19+B cells, CD4+CD25+ Treg cells and CD4+/CD8+ ratio at different time points before and after transplantation (P<0.05). CD16+CD56+ NK cells recovered the earliest and reached the level of pre-transplantation at 21 days post-transplantation. CD3+ T cells almost reached the pre-transplantation level at 60 days after transplantation, while CD8+ T cells exceeded the pre-transplantation level at 60 days after transplantation. The aGVHD occurred in 16 of 42 children, and the median time of aGVHD occurrence was 20.0 (6.0-36.0) days. At 28d and 60d after transplantation, the absolute count of CD16+ CD56+ NK cells in aGVHD group was lower than that in non-aGVHD group, the difference was statistically significant (P<0.05). Conclusions CD16+ CD56+ NK cells were the earliest lymphocyte subsets reconstructed after allo-HSCT in children. NK cell reconstitution is closely related to the occurrence of aGVHD after allo-PBSCT, which may be used as an effective predictor of prognosis in patients with aGVHD.
Na SONG , Ming SUN , Shanshan QI , Zhuo WANG , Li YANG , Wenjie LU , Min WU , Wei XIA , Yan CHEN , Hao XIONG . Clinical research on cellular immune reconstitution after allogeneic hematopoietic stem cell transplantation in children[J]. Journal of Clinical Pediatrics, 2022 , 40(5) : 388 -394 . DOI: 10.12372/jcp.2022.21e1384
[1] | Elfeky R, Lazareva A, Qasim W, et al. Immune reconstitution following hematopoietic stem cell transplantation using different stem cell sources[J]. Expert Rev Clin Immunol, 2019, 15(7): 735-751. |
[2] | Kim HO, Oh HJ, Lee JW, et al. Immune reconstitution after allogeneic hematopoietic stem cell transplantation in children: a single institution study of 59 patients[J]. Korean J Pediatr, 2013, 56(1): 26-31. |
[3] | 中华医学会血液学分会干细胞应用学组. 中国异基因造血干细胞移植治疗血液系统疾病专家共识(Ⅰ)-适应证、预处理方案及供者选择(2014年版)[J]. 中华血液学杂志, 2014, 35(8): 775-780. |
[4] | 中华医学会血液学分会干细胞应用学组. 中国异基因造血干细胞移植治疗血液系统疾病专家共识(Ⅲ)-急性移植物抗宿主病(2020年版)[J]. 中华血液学杂志, 2020, 41(7): 529-536. |
[5] | Pei XY, Zhao XY, Xu LP, et al. Immune reconstitution in patients with acquired severe aplastic anemia after haploidentical stem cell transplantation[J]. Bone Marrow Transplant, 2017, 52(11): 1556-1562. |
[6] | Park BG, Park CJ, Jang S, et al. Reconstitution of lymphocyte subpopulations after hematopoietic stem cell transplantation: comparison of hematologic malignancies and donor types in event-free patients[J]. Leuk Res, 2015, 39(12): 1334-1341. |
[7] | de Koning C, Plantinga M, Besseling P, et al. Immune reconstitution after allogeneic hematopoietic cell transplantation in children[J]. Biol Blood Marrow Transplant, 2016, 22(2):195-206. |
[8] | Ullah MA, Hill GR, Tey SK. Functional reconstitution of natural killer cells in allogeneic hematopoietic stem cell transplantation[J]. Front Immunol, 2016, 7: 144. |
[9] | Gao F, Ye Y, Gao Y, et al. Influence of KIR and NK cell reconstitution in the outcomes of hematopoietic stem cell transplantation[J]. Front Immunol, 2020, 11: 2022. |
[10] | Huttunen P, Taskinen M, Siitonen S, et al. Impact of very early CD4+ /CD8+ T cell counts on the occurrence of acute graft-versus-host disease and NK cell counts on outcome after pediatric allogeneic hematopoietic stem cell transplantation[J]. Pediatr Blood Cancer, 2015, 62(3): 522-528. |
[11] | Stern L, McGuire H, Avdic S, et al. Mass cytometry for the assessment of immune reconstitution after hematopoietic stem cell transplantation[J]. Front Immunol, 2018, 9: 1672. |
[12] | Chaudhry MS, Velardi E, Malard F, et al. Immune reconstitution after allogeneic hematopoietic stem cell transplantation: time to T up the thymus[J]. J Immunol, 2017, 198(1):40-46. |
[13] | 霍莹莹, 庞爱明, 程涛达. 异基因造血干细胞移植后造血及免疫重建研究进展[J]. 中华血液学杂志, 2020, 41(11): 958-963. |
[14] | Ritacco C, Ehx G, Grégoire C, et al. High proportion of terminally differentiated regulatory T cells after allogeneic hematopoietic stem cell transplantation[J]. Bone Marrow Transplant, 2021, 56(8):1828-1841. |
[15] | Bosch M, Khan FM, Storek J. Immune reconstitution after hematopoietic cell transplantation[J]. Curr Opin Hematol, 2012, 19(4): 324-335. |
[16] | Giaccone L, Faraci DG, Butera S, et al. Biomarkers for acute and chronic graft versus host disease: state of the art[J]. Expert Rev Hematol, 2021, 14(1): 79-96. |
[17] | Bunting MD, Varelias A, Souza-Fonseca-Guimaraes F, et al. GVHD prevents NK-cell-dependent leukemia and virus-specific innate immunity[J]. Blood, 2017, 129(5): 630-642. |
[18] | Zhang X, Peng Y, Fan Z, et al. Mesenchymal stem cells may ameliorate nephrotic syndrome post-allogeneic hematopoietic stem cell transplantation-case report[J]. Front Immunol, 2017, 8: 962. |
[19] | Shokouhi S, Bray S, Bakhtiyari S, et al. Effects of aGVHD and cGVHD on survival rate in patients with acute myeloid leukemia after allogeneic stem cell transplantation[J]. Int J Hematol Oncol Stem Cell Res, 2015, 9(3): 112-121. |
[20] | Sheng L, Mu Q, Wu X, et al. Cytotoxicity of donor natural killer cells to allo-reactive T cells are related with acute graft-vs.-host-disease following allogeneic stem cell transplantation[J]. Front Immunol, 2020, 11: 1534 |
/
〈 |
|
〉 |