부산대학교 도서관

Background: Chronic GVHD (cGVHD) is thought to be induced by donor T-cells, but mechanisms of cGVHD and the critical cellular subsets remain less well understood. In this study, we analysed T and B cell subsets in 44 patients (pts.) after allogeneic haematopoietic stem cell transplantation (alloHSCT). Methods: Peripheral blood samples from 12 pts. who never experienced cGVHD (group 1) and 12 pts. with resolved (group 2) and 20 pts. with active cGVHD (group 3) were analysed for lymphocyte subsets by FACS. Chronic GVHD was evaluated using criteria and guidelines of the National Institute of Health. Results: The absolute CD19+ B cell count (in Gpt/l) in cGVHD pts. was subnormal (group 2: median 0.14, range 0.008-0.69; group 3: median 0.01, range 0.001-2.59); normal limits: 0.20.4 gpt/l) and less than that of group 1 (median 0.237, range 0.05-0.55). Furthermore relative and absolute numbers of the CD27- B cell compartment, which include immature and transitional B cells, were lower in cGVHD pts. (group 2: 78%, median 0.12Gpt/l, range 0-0.66Gpt/l; group 3: 68%, median 0.01Gpt/l, range 0 -2.53Gpt/l) compared to pts. of group 1 (90%, median 0.20 Gpt/l, range 0.05-0.52Gpt/l). Although the relative number of cells of the CD 27+ memory B cell compartment was highest in the active cGVHD-group (22%) versus group 1 (10%) and 2 (12%) due to the lower CD19+ B cell count (in Gpt/l), the absolute number was lower in group 3 (median 0.02, range 0-0.96) compared to pts. of group 1 (median 0.17, range 0.04-0.65 gpt/l) and group 2 (median: 0.14, range 0-0.8). CD 27+IgD+IgM[+ or -]cells (in 10E6/l) could not detected in pts. with active cGVHD (except one patient with isolated cGVHD of the oral mucosa and dry eyes) (5%, median 0, range 0-66.6) in contrast to pts. of group 1 (20%, median 1.69, range 0-6.26) and group 2 (18%, median 1.23, range 0-10.53). No differences in absolute CD4+ and CD8+ T cell numbers as well as regulatory T cells were observed between the three groups. Conclusion: This small series confirms diminished B cell counts in pts. with cGVHD. Furthermore the loss of CD 27+IgD+IgM+ B cells in pts. with active cGVHD indicate functional asplenia in these pts. Analysis of B cell subsets can provide a diagnostic tool for monitoring cGVHD activity but has to be evaluated in a prospective study.
I. Hilgendorf (1), B. Mueller-Hilke (1), C. Junghanss (1), M. Leithauser (1), M. Freund (1), D. Wolff (2) (1) University of Rostock (Rostock, DE); (2) University of Regensburg (Regensburg, [...]