A Comparative Study Of Acute Graft-versus-host Disease And T-cell Subsets Reconstruction Between RIC-RH-PBSCT And MAC-RH-PBSCT

Objective: To compare and analyze the characteristics of acute graft-versus host disease(aGVHD)and the early reconstruction of T-cell subsets after our unique reduced intensity conditioning regimen related HLA haploidentical peripheral blood stem cell transplantation(RIC-RH-PBSCT)and myeloablative conditioning regimen related HLA haploidentical peripheral blood stem cell transplantation(MAC-RH-P BSCT).Methods: From January 2014 to September 2018,22 patients treated with RIC-RH-PBSCT in the hematologic center of the First Affiliated Hospital of Xinjiang Medical University,to analyze its aGVHD incidence,occurrence time,and early reconstruction of T-cell subsets after transplantation,compared with those of the 24 patients who received the MAC-RH-PBSCT.Results:(1)46 patients obtained rapid hematopoietic reconstruction,among them,the cumulative incidence of I-IV grade aGVHD and ?-? grade aGVHD was 52%(24/46)and 10.8%(5/46),mainly was skin type(19/29);The cumulative incidence of I-IV grade aGVHD and ?-? grade aGVHD in RIC group and MAC group was 50%(11/22)vs54.2%(13/24)(P> 0.05)and 13.6%(3/22)vs8.3%(2/24)(P> 0.05);There was no significant difference in the morbidity of aGVHD at +30d,+31d-+60d and +61d-+100d after transplantation(P>0.05).In both groups,CD3+and CD8+T lymphocytes reconstructed to the basic normal level in 3 months after transplantation,but CD4+T lymphocytes did not fully recover.After 9 months of observation,CD3+CD4+T lymphocytes in RIC group recovered faster than those in MAC group with significant difference(P=0.02).The ratio of CD4+/CD8+ in both groups was inverted within 9 months after transplantation.However,at 9-month after transplantation,the CD4+/CD8+ ratio in RIC group was higher than that in MAC group(P=0.003).At 30-day after transplantation,the ratio of CD4+/CD8+ was higher in patients with aGVHD than in patients without aGVHD(P=0.034).Conclusion: The occurrence of aGVHD was not significantly different between RIC-RH-PBSCT and MAC-RH-PBSCT,and the incidence of severe aGVHD was relatively low.CD3+ and CD8+T lymphocytes were rapidly reconstructed in bothgroups,while CD4+T lymphocytes were slowly reconstructed,but relatively quickly in RIC group.The occurrence of aGVHD may be correlated with CD4+T lymphocytes and CD4+/CD8+ ratio at 1-month after RIC-RH-PBSCT.