期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 19, 期 2, 页码 266-273出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2012.09.022
关键词
Double umbilical cord blood transplantation; Chimerism; HLA-specific monoclonal antibodies; Cord blood unit predominance; Engraftment kinetics
Single cord blood unit (CBU) predominance is usually established within the first month after double umbilical cord blood transplantation (UCBT). However, the kinetics of engraftment of the different leukocyte subsets and the mechanism of graft predominance is largely unknown. To investigate whether a differential engraftment might reveal a specific subset that could play a key role in the mechanism of graft predominance, we studied early engraftment kinetics of different leukocyte subpopulations by flow cytometry using human monoclonal antigen-specific human leukocyte antigen antibodies, directed against mismatched human leukocyte antigen-A or -B antigens between recipient and CBUs. Twenty-two patients, who had received a double UCBT preceded by a reduced-intensity conditioning regimen, were evaluated at days +11, +18, +25, and +32 posttransplantation. Single CBU predominance in the various leukocyte subsets was established within 18 days posttransplantation. CD4+ T cells of the dominant CBU showed early peripheral blood expansion. Moreover, chimerism in CD4+ and CD8+ T cell and natural killer cell subsets at day +11 was predictive of ultimate graft predominance. These findings show that engraftment kinetics of the various leukocyte subsets vary considerably after double UCBT and may suggest an important role for CD4+T cells in a presumed alloreactive graft-versus-graft rejection. (C) 2013 American Society for Blood and Marrow Transplantation.
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