Immune reconstitution of CD4+T cells after allogeneic hematopoietic stem cell transplantation and its correlation with invasive fungal infection in patients with hematological malignancies

Abstract

Objective: To explore the immune reconstitution of CD4+T cells after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and its relationship with invasive fungal infection (IFI) in patients with hematological malignancies. Materials and Methods: Forty-seven patients with hematological malignancies undergoing Allo-HSCT in Binzhou Medical University Hospital from February, 2010 to October, 2014 were selected. At 1, 2 and 3 months after transplantation, the immune subpopulations and concentration of cytokines were assessed respectively using flow cytometry (FCM) and enzyme linked immunosorbent assay (ELISA). The incidence of IFI after transplantation and its correlation with immune reconstitution of CD4+T cells were investigated. Results: The number of CD4+T cells and immune subpopulations increased progressively after transplantation as time went on, but the subpopulation cell count 3 months after transplantation was still significantly lower than in the control group (p<0.01). In comparison to the control group, the levels of interleukin-6 (IL-6) and IL-10 after transplantation rose evidently (p<0.01), while that of transforming growth factor-β (TGF-β) was decreased (p<0.01). There was no statistically significant difference level of interferon-γ (IFN-γ) (p>0.05). The incidence of IFI was 19.2% (9/47), and multivariate logistic regression revealed that IFI might be related to Th17 cell count (p<0.05), instead of Th1, Th2 and Treg cell counts as well as IL-6, IL-10, TGF-β and IFN-γ levels (p>0.05). Conclusions: After Allo-HSCT, the immune reconstitution of CD4+T cells is delayed and Th17 cell count decreases obviously, which may be related to occurrence of IFI.