The dynamics of B-cell reconstitution post allogeneic hematopoietic stem cell transplantation: A real-world study

作者全名："Zhou, Guangyu; Zhan, Qian; Huang, Lingle; Dou, Xi; Cui, Jin; Xiang, Lin; Qi, Yuhong; Wu, Sicen; Liu, Lin; Xiao, Qing; Chen, Jianbin; Tang, Xiaoqiong; Zhang, Hongbin; Wang, Xin; Luo, Xiaohua; Ren, Guosheng; Yang, Zesong; Liu, Lanxiang; Yan, Xinyu; Luo, Qin; Pei, Caixia; Dai, Yulian; Zhu, Yu; Zhou, Hao; Ren, Guilin; Wang, Li"

作者地址："[Zhou, Guangyu; Huang, Lingle; Dou, Xi; Liu, Lin; Xiao, Qing; Chen, Jianbin; Tang, Xiaoqiong; Zhang, Hongbin; Wang, Xin; Luo, Xiaohua; Yang, Zesong; Liu, Lanxiang; Yan, Xinyu; Zhu, Yu; Zhou, Hao; Ren, Guilin; Wang, Li] Chongqing Med Univ, Affiliated Hosp 1, Dept Hematol, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Zhan, Qian; Cui, Jin; Xiang, Lin; Qi, Yuhong; Luo, Qin; Pei, Caixia; Dai, Yulian] Chongqing Med Univ, Affiliated Hosp 1, Ctr Clin Mol Med Detect, Chongqing, Peoples R China; [Wu, Sicen] Chongqing Med Univ, Affiliated Hosp 1, Hlth Management Ctr, Chongqing, Peoples R China; [Ren, Guosheng] Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Mol Oncol & Epigenet, Chongqing, Peoples R China"

通信作者："Wang, L (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Hematol, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：JOURNAL OF INTERNAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001179493100001

JCR分区：Q1

影响因子：11.1

年份：2024

卷号：295

期号：5

开始页：634

结束页：650

文献类型：Article

关键词：allo-HSCT; B cells; immune reconstitution; mediation analysis; propensity score matching

摘要："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."

基金机构：Chongqing Medical University Program for Youth Innovation in Future Medicine

基金资助正文：No Statement Available