CAJ | 학술논문

目的研究重型β地中海贫血患儿造血干细胞移植预处理前后的细胞免疫功能变化,分析其与移植排斥之间的关系.方法测定25例次重型β地中海贫血患儿预处理前后外周血中CD3~+、CD3~+CD4~+、CD3~+CD8~+、CD3~-CD56~+细胞比率,以同期进行异基因造血干细胞移植的11例急性白血病患儿作对照,研究移植排斥与细胞免疫功能之间的关系.结果重型β地中海贫血组植入率65.2%,排斥率34.8%,急性白血病组植入率100%;CD3~+CD8~+T细胞百分比,重型β地中海贫血组在预处理前、后均高于急性白血病组(P均<0.05);CD3~-CD56~+细胞比率,重型β地中海贫血组预处理后较预处理前升高(P<0.05),而急性白血病组预处理后较预处理前显著降低(P<0.05);预处理前CD3~-CD56~+NK细胞比率,重型β地中海贫血排斥组高于植入组(P<0.05).结论 CD3~-CD56~+NK细胞可能与重型β地中海贫血移植排斥有关,可做为预测排斥的指标之一;CD3~+CD8~+T细胞与β地中海贫血移植排斥的关系有待进一步探索.
목적 연구중형β지중해빈혈환인조혈간세포이식예처리전후적세포면역공능변화,분석기여이식배척지간적관계.방법 측정25례차중형β지중해빈혈환인예처리전후외주혈중CD3~+、CD3~+CD4~+、CD3~+CD8~+、CD3~-CD56~+세포비솔,이동기진행이기인조혈간세포이식적11례급성백혈병환인작대조,연구이식배척여세포면역공능지간적관계.결과 중형β지중해빈혈조식입솔65.2%,배척솔34.8%,급성백혈병조식입솔100%;CD3~+CD8~+T세포백분비,중형β지중해빈혈조재예처리전、후균고우급성백혈병조(P균<0.05);CD3~-CD56~+세포비솔,중형β지중해빈혈조예처리후교예처리전승고(P<0.05),이급성백혈병조예처리후교예처리전현저강저(P<0.05);예처리전CD3~-CD56~+NK세포비솔,중형β지중해빈혈배척조고우식입조(P<0.05).결론 CD3~-CD56~+NK세포가능여중형β지중해빈혈이식배척유관,가주위예측배척적지표지일;CD3~+CD8~+T세포여β지중해빈혈이식배척적관계유대진일보탐색.
Objective To analyze the relationship between cell-mediated immune function during conditioning and graft rejection in patients with beta-thalassemia major. Methods Allogeneic hematopoietic stem cell transplantation was performed in 25 children with beta-thalassemia major and 11 with acute leukemia group.The percentages of T lymphocytes and natural killer (NK) cells in peripheral blood of these patients were detected with dual color immunofluorescence on day -10(before conditioning)and day-5(after conditioning),and the relationship between the cellular immune function and graft rejection was analyzed.Results All the patients with acute leukemia showed engraftment.The rate of graft rejection was 34.8% in the patients with beta-thalassemia major.Compared with the leukemic patients,the patients with beta-thalassemia showed significantly increased percentage of CD3~+CD8~+T lymphocytes before and after the conditioning (P<0.05).The percentage of CD3~-CD56~+ NK cells increased significantly in patients with beta-thalassemia major after the conditioning (P<0.05),but decreased markedly after conditioning in the leukemic patients(P<0.05).In patients with beta-thalassemia major and graft rejection,the CD3~-CD56~+ cell phenotype was predominant after conditioning but remained unchanged in those with engraftment.Conclusion CD3~-CD56~+ NK cells are probably associated with graft rejection in patients with beta-thalassemia major,and may serve as an index for predicting graft rejection following allogeneic hematopoietic stem cell transplantation.