Immune Reconstitution of CD4+T Cells after Allogeneic Hematopoietic Stem Cell Transplantation and its Correlation with Invasive Fungal Infection in Patients with Hematological Malignancies

Objective: To explore the immune reconstitution of CD4+T cells after allogeneic hematopoietic stem celltransplantation (Allo-HSCT) and its relationship with invasive fungal infection (IFI) in patients with hematologicalmalignancies. 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, 2and 3 months after transplantation, the immune subpopulations and concentration of cytokines were assessedrespectively using flow cytometry (FCM) and enzyme linked immunosorbent assay (ELISA). The incidenceof 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 transplantationas time went on, but the subpopulation cell count 3 months after transplantation was still significantly lowerthan in the control group (p<0.01). In comparison to the control group, the levels of interleukin-6 (IL-6) andIL-10 after transplantation rose evidently (p<0.01), while that of transforming growth factor-β (TGF-β) wasdecreased (p<0.01). There was no statistically significant difference level of interferon-γ (IFN-γ) (p>0.05). Theincidence of IFI was 19.2% (9/47), and multivariate logistic regression revealed that IFI might be related toTh17 cell count (p<0.05), instead of Th1, Th2 and Treg cell counts as well as IL-6, IL-10, TGF-β and IFN-γlevels (p>0.05).
Conclusions: After Allo-HSCT, the immune reconstitution of CD4+T cells is delayed and Th17cell count decreases obviously, which may be related to occurrence of IFI.