To investigate the correlation between the types and quantities of immune cells in the graft and early immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their influence on clinical prognosis. The clinical data of 83 patients with hematological diseases who received allo-HSCT in Shanxi Bethune Hospital from September 2020 to June 2023 were retrospectively analyzed. The number of mononuclear cells (MNC), CD34+ cells and lymphocyte subsets (including CD3+T, CD3+CD4+T(Th), CD3+CD8+T(Ts), NK cells and B cells) infused into the recipients was counted, and the peripheral blood lymphocytes were detected before conditioning and on days 14, 30, 60 and 100 post-HSCT. Multivariate analysis showed that the number of MNC in the graft affected the recovery of CD4+T lymphocytes after HSCT, and the number of CD4+T lymphocytes in the graft affected the recovery of NK cells and B cells after HSCT. The patient age, donor sex, stem cell source, degree of HLA matching, use of ATG before HSCT, the occurrence of acute graft-versus-host disease (aGVHD) after HSCT, and viral infection all affect the early cellular immune reconstitution post-HSCT. The number of infused cells had no significant impact on the median engraftment time for neutrophils and platelets after HSCT. Patients with lower numbers of CD3+T, CD4+T and B cells in the graft were more prone to viral infection after HSCT. However, the cells in the graft had no significant effect on disease recurrence or mortality. The recovery rate of lymphocyte count after allo-HSCT varies. The numbers of MNC and CD4+T cells in the graft may be related to the cellular immune reconstitution after HSCT, while the numbers of CD34+,CD3+T,CD8+T,NK and B cells have no significant effect on the cellular immune reconstruction. The numbers of CD3+T,CD4+T and B cells in the graft were negatively correlated with viral infection after HSCT, but the cellular components of the graft have no obvious influence on hematopoietic reconstitution, disease recurrence, death, recurrence-free survival(RFS) and overall survival(OS) after HSCT.
Wang et al. (Fri,) studied this question.