Guangyu Zhou, Qian Zhan, Lingle Huang, Xi Dou, Jin Cui, Lin Xiang, Yuhong Qi, Sicen Wu, Lin Liu, Qing Xiao, Jianbin Chen, Xiaoqiong Tang, Hongbin Zhang, Xin Wang, Xiaohua Luo, Guosheng Ren, Zesong Yang, Lanxiang Liu, Xinyu Yan, Qin Luo, Caixia Pei, Yulian Dai, Yu Zhu, Hao Zhou, Guilin Ren, Li Wang
{"title":"异体造血干细胞移植后 B 细胞重建的动态变化：真实世界研究。","authors":"Guangyu Zhou, Qian Zhan, Lingle Huang, Xi Dou, Jin Cui, Lin Xiang, Yuhong Qi, Sicen Wu, Lin Liu, Qing Xiao, Jianbin Chen, Xiaoqiong Tang, Hongbin Zhang, Xin Wang, Xiaohua Luo, Guosheng Ren, Zesong Yang, Lanxiang Liu, Xinyu Yan, Qin Luo, Caixia Pei, Yulian Dai, Yu Zhu, Hao Zhou, Guilin Ren, Li Wang","doi":"10.1111/joim.13776","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is crucial for preventing infections and relapse and enhancing graft-versus-tumor effects. B cells play an important role in humoral immunity and immune regulation, but their reconstitution after allo-HSCT has not been well studied.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this study, we analyzed the dynamics of B cells in 252 patients who underwent allo-HSCT for 2 years and assessed the impact of factors on B-cell reconstitution and their correlations with survival outcomes, as well as the development stages of B cells in the bone marrow and the subsets in the peripheral blood.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We found that the B-cell reconstitution in the bone marrow was consistent with the peripheral blood (<i>p</i> = 0.232). B-cell reconstitution was delayed by the male gender, age >50, older donor age, the occurrence of chronic and acute graft-versus-host disease, and the infections of fungi and cytomegalovirus. The survival analysis revealed that patients with lower B cells had higher risks of death and relapse. More importantly, we used propensity score matching to obtain the conclusion that post-1-year B-cell reconstitution is better in females. Meanwhile, using mediation analysis, we proposed the age-B cells-survival axis and found that B-cell reconstitution at month 12 posttransplant mediated the effect of age on patient survival (<i>p</i> = 0.013). We also found that younger patients showed more immature B cells in the bone marrow after transplantation (<i>p</i> = 0.037).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Our findings provide valuable insights for optimizing the management of B-cell reconstitution and improving the efficacy and safety of allo-HSCT.</p>\n </section>\n </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"295 5","pages":"634-650"},"PeriodicalIF":9.0000,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.13776","citationCount":"0","resultStr":"{\"title\":\"The dynamics of B-cell reconstitution post allogeneic hematopoietic stem cell transplantation: A real-world study\",\"authors\":\"Guangyu Zhou, Qian Zhan, Lingle Huang, Xi Dou, Jin Cui, Lin Xiang, Yuhong Qi, Sicen Wu, Lin Liu, Qing Xiao, Jianbin Chen, Xiaoqiong Tang, Hongbin Zhang, Xin Wang, Xiaohua Luo, Guosheng Ren, Zesong Yang, Lanxiang Liu, Xinyu Yan, Qin Luo, Caixia Pei, Yulian Dai, Yu Zhu, Hao Zhou, Guilin Ren, Li Wang\",\"doi\":\"10.1111/joim.13776\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is crucial for preventing infections and relapse and enhancing graft-versus-tumor effects. 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引用次数: 0
摘要
背景：异基因造血干细胞移植（allo-HSCT）后的免疫重建对于预防感染和复发以及提高移植物抗肿瘤效果至关重要。B细胞在体液免疫和免疫调节中发挥着重要作用，但异体造血干细胞移植后的B细胞重建尚未得到充分研究：在这项研究中，我们分析了 252 名接受异体 HSCT 2 年的患者的 B 细胞动态，评估了各种因素对 B 细胞重建的影响及其与生存结果的相关性，以及骨髓中 B 细胞的发育阶段和外周血中的亚群：我们发现骨髓中的 B 细胞重建与外周血中的 B 细胞重建一致（p = 0.232）。男性、年龄大于 50 岁、供体年龄较大、发生慢性和急性移植物抗宿主疾病、真菌和巨细胞病毒感染都会延迟 B 细胞重建。生存分析显示，B 细胞较少的患者死亡和复发的风险较高。更重要的是，我们利用倾向得分匹配法得出了女性患者一年后B细胞重建更好的结论。同时，通过中介分析，我们提出了年龄-B 细胞-生存轴，并发现移植后第 12 个月的 B 细胞重建中介了年龄对患者生存的影响（p = 0.013）。我们还发现，年轻患者在移植后骨髓中显示出更多的未成熟B细胞（p = 0.037）：我们的研究结果为优化 B 细胞重建管理、提高异体 HSCT 的疗效和安全性提供了有价值的见解。
The dynamics of B-cell reconstitution post allogeneic hematopoietic stem cell transplantation: A real-world study
Background
The immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is crucial for preventing infections and relapse and enhancing graft-versus-tumor effects. B cells play an important role in humoral immunity and immune regulation, but their reconstitution after allo-HSCT has not been well studied.
Methods
In this study, we analyzed the dynamics of B cells in 252 patients who underwent allo-HSCT for 2 years and assessed the impact of factors on B-cell reconstitution and their correlations with survival outcomes, as well as the development stages of B cells in the bone marrow and the subsets in the peripheral blood.
Results
We found that the B-cell reconstitution in the bone marrow was consistent with the peripheral blood (p = 0.232). B-cell reconstitution was delayed by the male gender, age >50, older donor age, the occurrence of chronic and acute graft-versus-host disease, and the infections of fungi and cytomegalovirus. The survival analysis revealed that patients with lower B cells had higher risks of death and relapse. More importantly, we used propensity score matching to obtain the conclusion that post-1-year B-cell reconstitution is better in females. Meanwhile, using mediation analysis, we proposed the age-B cells-survival axis and found that B-cell reconstitution at month 12 posttransplant mediated the effect of age on patient survival (p = 0.013). We also found that younger patients showed more immature B cells in the bone marrow after transplantation (p = 0.037).
Conclusion
Our findings provide valuable insights for optimizing the management of B-cell reconstitution and improving the efficacy and safety of allo-HSCT.
期刊介绍：
JIM – The Journal of Internal Medicine, in continuous publication since 1863, is an international, peer-reviewed scientific journal. It publishes original work in clinical science, spanning from bench to bedside, encompassing a wide range of internal medicine and its subspecialties. JIM showcases original articles, reviews, brief reports, and research letters in the field of internal medicine.
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