Allogeneic Hematopoietic Stem Cell Transplantation Graft-versus-host Disease Pathogenesis

ObjectiveTo explore the effect of costimulatory moleculars and CD25 expressed peripheral CD4+ T lymphocytes on graft-versus-host dusease(GVHD) after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods1.The 21 patients who suffered of hematology diseases or malignant solid tumors and were underwent allo-HSCT and 10 normal individuals were enrolled in the study.2.For the sake of difference conditioning regimens,we divided the 21 patients into two groups: patients undergoing non-myeloablative stem cell transplantation(NST) belong to group A,others undergoing traditional myeloablative stem cell transplantation belong to group B;we divide them into five groups for with GVHD or without GVHD and types of GVHD:group 1(group A with acute GVHD),group 2(group A with chronic GVHD), group 3(group B with acute GVHD), group 4(group B without GVHD), group 5(group A without GVHD).3.The levels of CD28,CD80,CD152 and CD25 expressions on peripheral CD4+ T lymphocytes were detected by three colors flow cytometry(FCM) in different time(before allo-HSCT,7day,14day,21day,30day after allo-HSCT,the time of GVHD and the time after GVHD treated).4.STR-PCR for detecting micro-satellites chimeras forming.Results1.All 21 patients achieved engraftment.By STR-PCR assay,12 cases formed complete chimeras(CC) and 9 cases formed mixed chimeras(MC).In group A,3 cases developed acute GVHD and 4 cases developed chronic GVHD;in group B,4 cases developed aGVHD.The incidence of GVHD and infection rates between group A and B has no difference(χ~2=3.711,P=0.144).2.Among these 21 cases,5 cases died:2 cases died of multiple organs function failure due to primary disease relapse,1 case died of bleeding in brain and 2 cases died of liver function failure for the sake of complicated with acute GVHD;others survive with disease free till present.3.The results of multivariate logistic regression modles and Kaplan-Meier survival curves...