Polyclonal anti T-lymphocyte antibody therapy monitoring in kidney transplant recipients: comparison of CD3+ T cell and total lymphocyte counts

ABSTRACT Objective: To investigate the correlation between total lymphocyte and CD3+ T cell counts in peripheral blood in renal transplant patients treated with anti-thymocyte globulin, and discuss related outcomes. Methods: A single-center, retrospective study involving 226 patients submitted to kidney transplant between 2008 and 2013, and treated with anti-thymocyte globulin for induction or treatment of cellular rejection. Doses were adjusted according to CD3+ T cell or total lymphocyte counts in peripheral blood. Results: A total of 664 paired samples were analyzed. The Spearman's correlation coefficient was 0.416 (p<0.001) for all samples combined; the overall Kappa coefficient was 0.267 (p<0.001). Diagnostic parameters estimated based on total lymphocyte counts were also calculated using the number of CD3+ T cells (gold standard), with a cut off of >20 cells/mm3. Conclusion: Total lymphocyte and CD3+ T cell counts in peripheral blood are not equivalent monitoring strategies in anti-thymocyte globulin therapy.

摘要 目的：探讨接受抗胸腺细胞球蛋白（anti-thymocyte globulin）治疗的肾移植患者外周血总淋巴细胞计数与CD3+ T细胞计数的相关性，并探讨相关转归。方法：本研究为单中心回顾性研究，纳入2008年至2013年间接受肾移植、且以抗胸腺细胞球蛋白诱导治疗或细胞排斥反应治疗的226例患者，给药剂量根据外周血CD3+ T细胞计数或总淋巴细胞计数进行调整。结果：共分析664份配对样本。所有合并样本的Spearman相关系数为0.416（p<0.001）；总体Kappa系数为0.267（p<0.001）。以CD3+ T细胞计数作为金标准，以外周血总淋巴细胞计数估算诊断参数，截断值设定为>20个/mm³。结论：在抗胸腺细胞球蛋白治疗中，外周血总淋巴细胞计数与CD3+ T细胞计数并非等效的监测策略。