The Role Of Co-stimulatory In The Immunotolerance Of Non-myeloablative Hematopoietic Stem Cell Transplantation

Objective: (1 ) To explore the importance of co-stimulatory in the immunotolerance of NST . (2) To explore the efficiency and toxicity of NST.Methods: (1) PB expression of CD137 CD28 in 18 patients who received NST at different stage and 12 normal controls was analyzed by immnofluorescence and flow cytometry. (2) Observing and studying on 18 patients "who received NST.Results: (1) PB of patients before transplantation and normal controls do not express CD137 While GVHD or decreasing of donor chimeristic rate occurs, PB expression of CD137 in patients is abnormally high. The expression level of CD137 is parallel inversely to the donor chimeristic rate in part of these patients. (2) Expression of CD28 has no difference between patients who are before transplantation and normal controls, and it' s much lower in three months after transplantation than normal controls. While GVHD and decreasing of donor chimeristic rate occur, the result comes the same. (3) NST makes more patients benefit from HSCT with rare complication which easy to deal with, and fewer composition of blood is infused. Its blood reconstitution is sooner and it costs fewer.Conclusion: (1) CD137 and CD28 are important to keep immunotolerance in NST. It's helpful to diagnosis some complications by analyzing the patients' PB expression of CD137. In early stage after NST, it's possibly independent on CD28-CD7 signal to activate T cells in patients. (2) NST is an effective therapy in the treatment of hematological disease. NST is a new concept and strategy in the treatment of hematological disease.