儿童单倍体造血干细胞移植后发生慢性移植物抗宿主病的免疫动力学特征与预测因素分析OA

Objective To investigate the immunological characteristics and predictive factors of chronic graft-versus-host disease(cGVHD)in children after haploidentical allogeneic hematopoietic stem cell transplantation(Haplo-HSCT)to provide a basis for early intervention.Methods A retrospective analysis was conducted on clinical and laboratory data of 64 children undergoing Haplo-HSCT.Peripheral blood lymphocyte subsets,immunoglobulins,and key components of the complement system were measured.Univariable and multivariable logistic regression analyses were used to identify predictors.Results The percentage of helper/inducer T lymphocytes and complement C3 levels were significantly higher in the cGVHD group(n=37)compared to the non-cGVHD group(n=27)(P<0.05),while the percentages of B cells and natural killer(NK)cells were significantly lower(P<0.05).Multivariate logistic regression identified the percentage of helper/inducer T lymphocytes(OR=1.144,P=0.012)and complement C3 level(OR=29.758,P=0.037)as independent predictors of cGVHD.Conclusions The development of cGVHD is closely associated with T-cell homeostasis imbalance,B-cell functional exhaustion,and abnormal activation of the complement system.The percentage of helper/inducer T lymphocytes and complement C3 levels may serve as potential predictive indicators for cGVHD occurrence.