造血干细胞移植(HSCT)是儿童β-地中海贫血的唯一治愈性治疗方法。然而,它通常诱导移植物抗宿主病(GVHD),这与并发症有关。在本研究中,我们使用环磷酰胺(Cy)治疗1例HSCT后地中海贫血患者,以减少GVHD的不良反应.我们监测了粒细胞的数量和表型。在这个案例研究中,一名11岁的女性患者,诊断为重型β-地中海贫血(佩萨罗II级),在用动员的CD34+细胞进行HSCT之前和之后用Cy处理。相对和绝对粒细胞计数,以及CD33+CD11b+细胞计数,HSCT后显著增加,直到第56天。然而,它们在56天后突然开始减少,并伴有严重的腹泻,皮疹,与第-12天相比,胆红素水平下降。此外,与第-12天相比,IL-22水平增加到第56天,然后下降,而IDO水平在第56天后持续上升。我们的数据表明IL-22和IDO作为GVHD评估的生物标志物的潜在用途。这也表明Cy通过增加CD33+CD11b+细胞促进HSCT重建,这可能在降低GVHD风险中起关键作用。然而,需要进一步的研究来阐明GVHD复发的机制.
Hematopoietic stem cell transplantation (
HSCT) is the only curative therapy for β-thalassemia major in children. However, it often induces graft-versus-host-disease (GVHD), which is associated with complications. In the present study, we used cyclophosphamide (Cy) to treat a thalassemia patient post-
HSCT to reduce the adverse effects of GVHD. We monitored the numbers and phenotype of granulocytes. In this case study, an 11-year-old female patient, diagnosed with β-thalassemia major (Pesaro class II), was treated with Cy before and after
HSCT with mobilized CD34+ cells. Both the relative and absolute granulocyte counts, as well as CD33+CD11b+ cell counts, increased significantly after
HSCT until day 56. However, they suddenly began to decrease after day 56, accompanied by severe diarrhea, skin rash, and a decrease in bilirubin levels compared to day -12. Furthermore, compared to day -12, IL-22 levels increased until day 56, and then decreased, while IDO levels continued to rise after day 56. Our data suggest the potential use of IL-22 and IDO as biomarkers for GVHD assessment. It also indicates that Cy promotes
HSCT reconstitution by increasing CD33+CD11b+ cells, which may play a crucial role in reducing GVHD risks. However, further studies are needed to elucidate the mechanism behind GVHD recurrence.