目的:探讨同胞供者全相合脐血移植治疗重型β地中海贫血后免疫重建的特点。方法:8例同胞供者HLA全相合脐血移植成功治疗重型β地中海贫血患者,采用流式细胞仪分别在移植后1、3、6、12个月检测T细胞亚群。结果:该组患者植入证据显示均移植成功,在移植后4周内恢复造血重建;3例发生Ⅰ-Ⅱ急性移植物抗宿主病,无慢性移植物抗宿主病发生;移植后CD3+细胞1个月为(45.3±27.2)%,3个月为(66.7±10.4)%,6个月为(68.7±14.5)%,12个月为(71.7±10.2)%;移植后CD4+细胞1个月为(13.3±7.8)%,3个月为(21.8±11.6)%,6个月为(19.4±10.9)%,12个月为(30.1±10.4)%;移植后CD8+细胞1个月为(32.1±15.4)%,3个月为(30.6±10.9)%,6个月为(26.9±7.3)%,12个月为(28.1±5.6)%;移植后CD3-CD19+细胞1个月为(6.4±5.6)%,3个月为(12.7±3.4)%,6个月为(16.3±7.3)%,12个月为(16.7±5.7)%;移植后CD3-CD16+CD56+细胞1个月为(16.4±7.4)%,3个月为(15.9±7.6)%,6个月为(14.7±6.6)%,12个月为(15.6±3.4)%。结论:同胞供者HLA全相合脐血移植治疗重型β地中海贫血后1个月CD8+细胞逐渐恢复正常,移植后3个月时CD3+细胞和NK细胞逐渐恢复正常水平,移植后6个月后CD4+和CD19+细胞表达水平逐渐恢复达正常水平。
Objective:To investigate the characteristics of immune reconstitution after umbilical cord blood transplantation (UCBT) in patients with severe β-thalassemia.Methods:Eight severe β-thalassemia patients received HLA-identical sibling UCBT and lymphocyte subsets of each patients were examined using flow cytometry at 1,3,6 and 12 months after the transplantation.Results:Within 4 weeks following successful UCBT,haematopoiesis recovered in all patients without acute or chronic GVHD.At months 1,3,6 and 12 posttransplant,CD3+ cells reached a mean value of (45.3±27.2)%,(66.7±10.4)%,(68.7±14.5)% and (71.7±10.2)%,CD4+ cells reached (13.3±7.8)%,(21.8±11.6)%,(19.4±10.9)% and (30.1±10.4)%,CD8+ cells reached (32.1±15.4)%,(30.6±10.9)%,(26.9±7.3)% and (28.1±5.6)%,CD3-CD19+cells reached (6.4±5.6)%,(12.7±3.4)%,(16.3±7.3)% and (16.7±5.7)% and CD3-CD16+CD56+ cells reached (16.4±7.4)%,(15.9±7.6)%,(14.7±6.6)% and (15.6±3.4)%,respectively.Conclusion:For severe β-thalassemia patients undergoing UCBT,CD8+ cells,CD3+ cells as well as NK cells,and CD4+ cells as well as CD19+ cells recover to normal values gradually at months 1,3 and 6 month postgraft,respectively.