Objective: To evaluate possible effects of Gelctin-9 on acute graft versus host disease (aGVHD) development and clinical outcomes in patients before and afer allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: Peripheral blood samples were obtained from 29 patients and 15 healthy volunteers with heparin anticoagulant tubes. Samples were analyzed using ELISA kits to measure the serum concentrations of Galectin-9. Results: Patients developing aGVHD had significantly lower level of Galectin-9 [ (7.96±1.18) μg/L] before allo-HSCT compared with those not developing aGVHD [ (12.37±0.97) μg/L, P<0.001]. And after allo-HSCT, the consentration of Galectin-9 increased markedly in patients developing aGVHD [ (17.78±1.78) μg/L] compared with those not developing aGVHD [ (9.45±0.80) μg/L, P<0.001]. Patients developing 3-4 grade aGVHD had significantly higher level of Galectin-9 [ (23.25±2.59) μg/L] compared with those developing 1-2 grade aGVHD [ (14.37±1.45) μg/L, P=0.008] and those without aGVHD [ (9.45±0.80) μg/L, P<0.001]. The patients with lower level of Galectin-9 after allo-HSCT (<13.61 μg/L) showed more favorable clinical outcomes compared with those with higher level of Galectin-9 (≥13.61 μg/L) . The 3-year overall survival rates were (100.00±6.05) % and (69.23±12.80) %, respectively (P=0.009) . The cumulative incidence of non-relapse mortality was significantly higher in high Galectin-9 group [ (23.08±11.69) %] in comparison with low Gaelctin-9 group [ (0.00±7.39) %] (P=0.023) . There was no significant difference between the two groups in terms of the cumulative incidence of relapse. The cumulative incidence of relapse at 3 years were (8.33±7.98) % and (12.50±8.27) % in high and low Galectin-9 groups, respectively (P=0.708) . Conclusions: The serum concentration of Galectin-9 at the time of engraftment after allo-HSCT may be used as a predictor for the development and severity of aGVHD. Galectin-9 might be considered as a potential new approach to regulate transplant rejection to achieve desirable survival.
目的： 探讨外周血半乳糖凝集素9（Galectin-9）水平对异基因造血干细胞移植（allo-HSCT）后急性GVHD的预测作用。 方法： 采集29例白血病患者allo-HSCT前、后及15例健康志愿者的外周血标本（肝素抗凝），用酶联免疫吸附测定法检测Galectin-9水平。 结果： 急性GVHD组（13例）移植前Galectin-9水平低于未发生急性GVHD组（16例）[（7.96±1.18）μg/L对（12.37±0.97）μg/L，P<0.001]。急性GVHD组植活时Galectin-9水平高于未发生急性GVHD组[（17.78±1.78）μg/L对（9.45±0.80）μg/L，P<0.001]，Ⅲ/Ⅳ度急性GVHD组（4例）Galectin-9水平[（23.25±2.59）μg/L]高于Ⅰ/Ⅱ度急性GVHD组（9例）[（14.37±1.45）μg/L]和未发生急性GVHD组（16例）[（9.45±0.80）μg/L]（P=0.008，P<0.001）。移植后Galectin-9高表达组（≥13.61 μg/L，13例）3年总生存率低于Galectin-9低表达组（<13.61 μg/L，16例）[（69.23±12.80）%对（100.00±6.05）%，P=0.009]，非复发死亡率高于低表达组[（23.08±11.69）%对（0.00±7.39）%，P=0.023]，3年累积复发率差异无统计学意义[（8.33±7.98）%对（12.50±8.27）%，P=0.708]。 结论： 移植前及移植后造血干细胞植活时外周血Galectin-9水平有助于评估急性GVHD的发生风险。.
Keywords: Allogenetic hematopoietic stem cell transplantation; Galectin 9; Graft versus host disease.