• J. Intern. Med. · May 2024

    The dynamics of B-cell reconstitution post allogeneic hematopoietic stem cell transplantation: A real-world study.

    • Guangyu Zhou, Qian Zhan, Lingle Huang, Xi Dou, Jin Cui, Lin Xiang, Yuhong Qi, Sicen Wu, Lin Liu, Qing Xiao, Jianbin Chen, Xiaoqiong Tang, Hongbin Zhang, Xin Wang, Xiaohua Luo, Guosheng Ren, Zesong Yang, Lanxiang Liu, Xinyu Yan, Qin Luo, Caixia Pei, Yulian Dai, Yu Zhu, Hao Zhou, Guilin Ren, and Li Wang.
    • Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China.
    • J. Intern. Med. 2024 May 1; 295 (5): 634650634-650.

    BackgroundThe immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is crucial for preventing infections and relapse and enhancing graft-versus-tumor effects. B cells play an important role in humoral immunity and immune regulation, but their reconstitution after allo-HSCT has not been well studied.MethodsIn this study, we analyzed the dynamics of B cells in 252 patients who underwent allo-HSCT for 2 years and assessed the impact of factors on B-cell reconstitution and their correlations with survival outcomes, as well as the development stages of B cells in the bone marrow and the subsets in the peripheral blood.ResultsWe found that the B-cell reconstitution in the bone marrow was consistent with the peripheral blood (p = 0.232). B-cell reconstitution was delayed by the male gender, age >50, older donor age, the occurrence of chronic and acute graft-versus-host disease, and the infections of fungi and cytomegalovirus. The survival analysis revealed that patients with lower B cells had higher risks of death and relapse. More importantly, we used propensity score matching to obtain the conclusion that post-1-year B-cell reconstitution is better in females. Meanwhile, using mediation analysis, we proposed the age-B cells-survival axis and found that B-cell reconstitution at month 12 posttransplant mediated the effect of age on patient survival (p = 0.013). We also found that younger patients showed more immature B cells in the bone marrow after transplantation (p = 0.037).ConclusionOur findings provide valuable insights for optimizing the management of B-cell reconstitution and improving the efficacy and safety of allo-HSCT.© 2024 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

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