Editor’s Note: Allogeneic hematopoietic stem cell transplantation (HSCT) is the classical treatment for curing beta-thalassemia major. With the continuous maturity of HSCT technology and supportive therapy over the past two decades, the choice of HSCT methods has expanded from classical matched sibling donor transplantation to matched unrelated donor transplantation and haploidentical transplantation. The commonly used stem cell types have also gradually transitioned from bone marrow hematopoietic stem cells to mobilized peripheral blood stem cells. Additionally, cord blood stem cells from related or unrelated donors have been widely used. From April 14th to 17th, 2024, the 50th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT) was held in Glasgow, United Kingdom. The conference focused on the latest advances in stem cell transplantation and cell therapy, driving towards better clinical outcomes for patients with hematological diseases and hematologic malignancies. At the meeting, Professor Chunfu Li from the Southern Chunfu (Pediatric) Hematology Research Institute, High-performance Medicine (Hematology) Guangdong Research Center, reported a clinical study comparing immune reconstitution, graft-versus-host disease (GVHD), and viral infections in patients with beta-thalassemia major treated with stem cell transplantation from different sources. The following is a compiled summary of the content for readers’ enjoyment.
Research Methods: A total of 198 patients with beta-thalassemia major who underwent allogeneic hematopoietic stem cell transplantation at our hospital between January 2018 and December 2022 were included in this study. Among them, 56 cases were in the MUD group, 45 cases were in the Haplo group, and 97 cases were in the TDH group. The proportions and absolute counts of lymphocyte subsets at 12 months after transplantation were detected using four-color flow cytometry for the three different donor types, and the immune reconstitution, GVHD, and viral infection situations were analyzed and compared.
Research Results: At 12 months after transplantation, compared with the Haplo and TDH groups, the MUD group showed significant differences (P < 0.05) in the proportions of helper T cells (CD3+CD4+), cytotoxic T cells (CD3+CD8+T), B cells (CD3-CD19+), NK cells (CD3-CD56+), and regulatory T cells (Tregs). The MUD group exhibited faster immune reconstitution, with no significant differences observed between the Haplo and TDH groups. There were statistically significant differences (P < 0.05) in the incidence of chronic GVHD between the MUD and Haplo groups, with a lower incidence of chronic GVHD in the MUD group. When comparing the TDH group with the Haplo group, there was a statistically significant difference (P < 0.05) in the incidence of chronic GVHD, with a higher incidence in the Haplo group. There were statistically significant differences (P < 0.05) in the occurrence of viral infections among the MUD, Haplo, and TDH groups, with a lower incidence in the MUD group and no significant difference between the Haplo and TDH groups.
Research Conclusion: Immune reconstitution was faster in the MUD group compared to the Haplo and TDH groups, with lower rates of GVHD and viral infections. When comparing the Haplo and TDH groups, the incidence of chronic GVHD was higher in the Haplo group.
