在哈普罗同一血型造血干细胞移植后儿童的免疫复合
Saranthorn Apasuthirat1, Nopporn Apiwattanakul1, Usanarat Anurathapan1
1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
International journal of laboratory hematology
|April 22, 2024
概括
用移植后的环胺进行顺序性干细胞移植的儿科患者表现出免疫复原的延迟和更高的病毒感染风险. 添加抗T淋巴细胞球蛋白进一步阻碍了T细胞的恢复,并增加了BK病毒的活性.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 儿科瘤学 儿科瘤学
背景情况:
- 儿科患者的免疫复制 (IR) 动力学需要进一步的研究,这些儿科患者接受了用移植后的环胺 (PTCy) 进行的单一血型造血干细胞移植 (HSCT).
- 在儿童中,哈普罗同一性和HLA匹配的HSCT之间的IR模式的比较对于理解移植后的结果至关重要.
研究的目的:
- 为了比较儿科患者的免疫复合模式,经过与PTCy相同的HSCT与HLA匹配的HSCT相比.
- 在这些儿科HSCT接受者中识别病毒感染的风险因素.
主要方法:
- 在HSCT前和12个月后,对淋巴细胞子集的前性测量.
- 在血液和尿液中监测细胞巨型病毒 (CMV),爱斯坦-巴尔病毒,腺病毒和BK病毒 (BKV) 的病毒载荷.
主要成果:
- 与HLA匹配的受试者相比,在HSCT后1个月,与HLA匹配的受试者相比,Haploidentical HSCT受试者表现出明显较低的T细胞和T辅助细胞中位数.
- 在整个第一年,在平分异性组中观察到T细胞子集和B细胞的延迟恢复.
- 增加的BKV出血性囊炎的发病率,血液CMV,和尿液腺病毒的重新激活被注意到在单一的组. 添加抗T淋巴细胞球蛋白 (ATG) 进一步延迟了T细胞的恢复,并增加了BKV的重新激活.
结论:
- 与HLA匹配的HSCT相比,带有PTCy的儿科哈普罗同一性HSCT与延迟的免疫复原和更高的病毒再激活风险有关.
- 与PTCy一起使用ATG会加剧T细胞恢复延迟,并增加BKV重新激活的风险.
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