[Effect of Graft Composition on Viral Infection and Survival after Allogeneic Hematopoietic Stem Cell Transplantation].

OBJECTIVE

To investigate the effect of infusing different doses of graft cells on viral infections and survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS

Clinical data of 99 patients with hematological diseases who underwent allo-HSCT in Shanxi Bethune Hospital were retrospectively analysed. The proportion of mononuclear cells (MNC) was counted microscopically, the proportions and absolute counts of CD34+ cells and lymphocyte subsets (including CD3+T, CD4+T, CD8+T, CD4+CD8+T, B, and NK cells) were detected by flow cytometry, and the infusion dose of each cell types was calculated. The patients were divided into high-dose group and low-dose group based on the median value of the infused cell dose. The effects of different doses of various graft cells on post-transplant viral infections (CMV, EBV, BKV) and survival were analyzed.

RESULTS

The low-dose MNC (< 7.97×108/kg) and high-dose CD4+CD8+T cell (≥3.02×106/kg) groups had a higher Epstein-Barr virus (EBV) infection rate (P =0.031; P =0.020). The high-dose CD34+ cell group and low-dose CD3+ T, CD8+ T and natural killer (NK) cell groups showed a trend toward higher EBV infection rates, but the differences were not statitsically significant (P >0.05). There was no significant difference in the rates of EBV infection between the high-dose and low-dose groups of CD4+T and B cells (P >0.05). Multivariate analysis revealed that the doses of MNC and CD4+CD8+ T cells in the graft were independent factors influencing EBV infection (P =0.023; P =0.016). The doses of cells in the graft showed no significant impact on CMV and BKV infection, or patient survival (P >0.05).

CONCLUSION

Infusing a lower dose of MNC and a higher dose of CD4+CD8+T cells increases the risk of EBV infection, but does not affect the survival outcome.