Differential Analysis Of Lymphocyte Subsets Typing In Different Risk Stratification Of GVHD Patients

Objective The study intends to monitor the distribution and changes of lymphocyte cell subsets in GVHD patients,sorting strategy of different surface mark combinations,proving that specific cell subsets to effectively predict and evaluate disease development during GVHD.Methods From October 2020 to February 2022,the patients who received hematopoietic stem cell transplantation from Hematology department of Affiliated Hospital of Zunyi Medical University,Hematology Department of The Second Affiliated Hospital of Zunyi Medical University and Hematology Medical Center of the Second Affiliated Hospital of Army Military Medical University were recruited.During this period,they also maintained regular follow-up.Flow cytometry analysis was used to detect the ratio of lymphocyte subpopulations in patients who received allogeneic hematopoietic stem cell transplantation during the same period with chronic graft-versus-host disease(c GVHD group,n=45)and no transplant-related complications(chronic control group,n=13)and patients with acute graft-versus-host disease(a GVHD group,n=5)and no transplant-related complications(acute control group,n=10)(acute control group).Primary diagnoses of recruited patients include ALL,AML,CML,MDS,SAA,andβ-thalassemia major.The median time to occurrence of c GVHD was 373.9 days(47 days to 1328 days).The median time to occurrence of a GVHD was 60 days(50 days to 71 days).Peripheral blood(PB)samples were collected for each patient when GVHD occurred during the course of the disease or on the day of follow-up.Results The distribution of PB Tregs and transitional B cells in c GVHD group were significantly reduced,and the distribution of CD19~+B lymphocytes was higher than that in the control group.Tregs in c GVHD group were significantly lower than those in the control group.The distribution of Th17-like cells in patients with moderate c GVHD was significantly higher than patients with mild and severe c GVHD.CD19~+B lymphocytes showed higher distribution in patients with mild and moderate c GVHD.Comparing different targeted organs of c GVHD,for patients with skin lesions and liver damage only the Tregs level was significantly lower than control group,while the distribution of follicular helper T cells in patients with skin and liver damage was significantly higher than patients with only mucous membrane or eye organ involvement.Transitional B cells in c GVHD group were significantly higher than the c GVHD group.The a GVHD group had no related results because there were no related cases.Analysis of the results of a GVHD study because there are too few cases of graft-versus-host disease,the results cannot be analyzed.Conclusion The detection and analysis of lymphocyte cell subsets which was selected through different sorting strategies after HSCT.Treg cells,transitional B cells and Tfh cells that was an important reference index to c GVHD clinical diagnosis,treatment and follow up.Compared with the control group,the decreased distribution of Treg cells and transitional B cells in PB,and the increased level of CD19~+B cells suggest that the risk of c GVHD is likely to increase;Compared with the control group,the increase of Th17 cell distribution and the decrease of transitional B cell suggest that patients with c GVHD are more likely to aggravate the severity of the disease;Compared with the control group,the increased distribution of TFH cells suggests that patients with c GVHD may have multiple organ injury.