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 graft-versus-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.
题目: 移植物中浆细胞样树突状细胞回输剂量对异基因造血干细胞移植后CMV感染的影响分析.
目的: 探索移植物中浆细胞样树突状细胞（pDC）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pDC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pDC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pDC可能与移植后早期的CMV感染有关，高剂量的pDC回输可能会对移植后CMV感染起到防护作用。.
Keywords: allogeneic hematopoietic stem cell transplantation; cell dose; cytomegalovirus; graft; plasmacytoid dendritic cell.