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儿童异基因造血干细胞移植后细胞免疫重建的临床研究 被引量:4
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作者 宋娜 孙鸣 +7 位作者 祁闪闪 王卓 杨李 卢文婕 吴旻 夏维 陈燕 熊昊 《临床儿科杂志》 CAS CSCD 北大核心 2022年第5期388-394,共7页
目的探讨儿童异基因造血干细胞移植(allo-HSCT)后免疫重建的临床特性。方法选取2019年7月至2020年10月接受allo-HSCT且临床资料完整的患儿为研究对象。动态监测患儿移植后第0、14、21、28、60及100 d外周血淋巴细胞亚群(CD3^(+)T细胞、C... 目的探讨儿童异基因造血干细胞移植(allo-HSCT)后免疫重建的临床特性。方法选取2019年7月至2020年10月接受allo-HSCT且临床资料完整的患儿为研究对象。动态监测患儿移植后第0、14、21、28、60及100 d外周血淋巴细胞亚群(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD16^(+)CD56^(+)NK细胞、CD19^(+)B细胞、CD4^(+)CD25^(+)Treg细胞)绝对计数;将患儿按有无急性移植物抗宿主病(aGVHD)分为non-aGVHD组和aGVHD组,比较两组间淋巴细胞亚群的差异。结果共75例患儿接受allo-HSCT,其中移植后满100 d、临床资料完整的42例患儿纳入本研究,男20例、女22例,中位年龄5.4(2.8~9.3)岁。移植前后不同时间点之间患儿CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD16^(+)CD56^(+)NK细胞、CD19^(+)B细胞、CD4^(+)CD25^(+)Treg细胞水平以及CD4^(+)/CD8^(+)比值差异均有统计学意义(P<0.05)。其中CD16^(+)CD56^(+)NK细胞恢复最快,在移植后21 d基本可达到移植前水平;CD3^(+)T细胞在移植后60 d基本可以达到移植前水平,CD8^(+)T细胞到移植后60 d已超过移植前水平。42例患儿中发生aGVHD 16例,aGVHD发生的中位时间为20.0(6.0~36.0)d。移植后28 d和60 d,aGVHD组CD16^(+)CD56^(+)NK细胞绝对计数均低于non-aGVHD组,差异有统计学意义(P<0.05)。结论儿童allo-HSCT后淋巴细胞亚群中重建最早的为CD16^(+)CD56^(+)NK细胞。NK细胞重建与aGVHD的发生密切相关,或有助于早期识别aGVHD患儿。 展开更多
关键词 异基造血干细胞移植 淋巴细胞亚群 急性移植物抗宿主病 儿童
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Surveillance of CMV Infection in allo-HSCT Recipients and Guidance on Preemptive Therapy by RQ-PCR
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作者 LI Yan GAO Li +9 位作者 WANG Li-Li DING Yi XU Yuan-Yuan LI Hong-Hua JING Yu BO Jian HUANG Wen-Rong WANG Quan-Shun GAO Chun-Ji YU Li 《中国实验血液学杂志》 CAS CSCD 北大核心 2013年第1期161-168,共8页
In order to study the epidemiological characteristics of cytomegalovirus(CMV)infection in allogeneichematopoietic stem cell transplantation(allo-HSCT)recipients by means of plasma real time quantitative polymerasechai... In order to study the epidemiological characteristics of cytomegalovirus(CMV)infection in allogeneichematopoietic stem cell transplantation(allo-HSCT)recipients by means of plasma real time quantitative polymerasechain reaction(RQ-PCR),141 adult patients undergoing allo-HSCT between January 2008 and June 2010 were seriallymonitored by RQ-PCR for detecting CMV and guiding the preemptive therapy followed up to 180 days post-HSCT.Theresults showed that the incidence of CMV infection and CMV pneumonia was 81.5%and 2.9%respectively,whichmainly occurred within 2 months post-HSCT.Single-therapy with ganciclovir(GCV)for 63 patients or foscarnet 6patients was performed for preemptive therapy.The total efficacy was 87.8%,and the response patterns were different.CMV infection was more frequent in female patients(P=0.044),and those with aGVHD(P=0.043),using ATG orbasiliximab in conditioning regimens(P=0.049),as well as earlier in patients using ATG or basiliximab or those withaGVHD(P=0.007;P=0.000).The aGVHD,maximum load,positive times of CMV-DNA detection and therapyduration all correlated with the efficacy(P<0.05).It is concluded that the incidence of CMV infection is still high afterHSCT.Plasma RQ-PCR assay for CMV-DNA shows a strong correlation with the clinical outcome of CMV infection,which is useful and suitable for management of CMV infection in HSCT. 展开更多
关键词 allogeneic hematopoietic stem cell transplantation cytomegalovirus infection real-time quantitativePCR preemptive therapy
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