摘要
目的:探索移植物中浆细胞样树突状细胞(p DC)回输剂量与异基因造血干细胞移植后巨细胞病毒(CMV)感染之间的相关性。方法:回顾性分析2020年8月20日至2021年6月11日在苏州大学附属儿童医院接受异基因造血干细胞移植的80例患儿的临床资料。采用流式细胞术检测其移植物样本中的树突状细胞亚群比例和T细胞亚群比例并计算每种细胞的回输剂量。移植后每周监测患儿外周血中的CMV-DNA拷贝数。随访截止日期为2021年12月31日。结果:80例患儿均获得造血重建,51例在移植后100 d内发生CMV感染,累计发生率为63.8%±5.4%,包括2例进展为CMV疾病。单因素分析结果显示,DC和p DC的回输剂量与移植后100 d内的CMV感染具有显著相关性(P<0.05);多因素分析结果表明,高剂量回输p DC是移植后100 d内发生CMV感染的独立保护因素(P<0.05)。至随访期结束,7例患儿死于移植相关并发症,其中2例死于CMV疾病,2例死于广泛性慢性移植物抗宿主病,3例死于毛细血管渗漏综合征,患儿总体生存率为91.2%。结论:移植物中的p DC可能与移植后早期的CMV感染有关,高剂量的p DC回输可能会对移植后CMV感染起到防护作用。
Objective:To investigate the correlation between plasmacytoid dendritic cell(pDC)dose in grafts and the occurrence of cytomegalovirus(CMV)infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:The clinical data of 80 children who received allo-HSCT in Children's Hospital of Soochow University from August 20,2020 to June 11,2021 were retrospectively analyzed.Proportions of DC subsets and T-cell subsets in grafts were detected by flow cytometry in order to calculate infused cell dose of each cell.Weekly monitoring of CMV-DNA copies in peripheral blood for each child were performed after transplantation.The last follow-up date was December 31,2021.Results:All the children gained hematopoietic reconstitution.CMV infection was observed in 51 children(63.8%±5.4%)within the first 100 days after transplantation,including 2 cases developing CMV disease.Univariate analysis indicated that infused doses of DC and pDC were significantly associated with CMV infection within 100 days after allo-HSCT(P<0.05).Multivariate analysis indicated that a high dose infusion of pDC was an independent protective factor for CMV infection within 100 days after allo-HSCT(P<0.05).By the end of follow-up,7 children died of transplantation-related complications,including 2 deaths from CMV disease,2 deaths from extensive chronic graftversus-host disease,and 3 deaths from capillary leak syndrome.The overall survival rate was 91.2%.Conclusion:The pDC in grafts may be associated with early infection of CMV after allo-HSCT,while a high infused pDC dose may serve as a protective factor for CMV infection after transplantation.
作者
姚笛
田园园
卢俊
肖佩芳
凌婧
郑德菲
高静
范丽艳
郑佳佳
李捷
胡绍燕
YAO Di;TIAN Yuan-Yuan;LU Jun;XIAO Pei-Fang;LING Jing;ZHENG De-Fei;GAO Jing;FAN Li-Yan;ZHENG Jia-Jia;LI Jie;HU Shao-Yan(Department of Hematology,Children's Hospital of Soochow University,Suzhou 215000,Jiangsu Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2023年第4期1184-1191,共8页
Journal of Experimental Hematology
基金
国家自然基金项目(81970163,82170218,82100229)
中国博士后科学基金(2020M681722)
江苏省科技厅项目(BE2021654)
江苏省卫健委项目(ZD2021006)
苏州市卫健委项目(GSWS2020039)。
