We prospectively validated the previously reported L-index, which reflects both the intensity and duration of lymphopenia, and further evaluated it using a lymphocyte subset analysis after allogeneic hematopoietic stem cell transplantation (HSCT) (n = 30). The L-index was defined as the area over the lymphocyte curve during lymphopenia (<700/μl), and calculated from the start of conditioning to day30 (L-index(30)) and day100 (L-index(100)). The lymphocyte subset including CD3, CD4, CD8, CD19 and CD56 was analyzed before and at 14, 21, 28, 42, 56, 70, and 84 days after HSCT. Cytomegalovirus (CMV) antigenemia was detected as >3 cells/2 slides by the C10/11 method in 21 cases (CMV-AG ≥3 group) at a median of 34 days. L-index(30) was significantly higher in the CMV-AG ≥3 group than in the CMV-AG <3 group (median 20,358 vs 17,235, P = .028). Recovery of the CD4+ and CD56+ cell counts between days 14 and 28 after HSCT was impaired in the CMV-AG ≥3 group. Regarding graft-versus-host disease (GVHD), grade II-IV acute GVHD was identified in 14 patients (GVHD group) at a median of 31 days. L-index(30) was significantly lower in the GVHD group (median 19,048 vs 22,256, P = .043). Recovery of CD3+ cells including both CD4+ and CD8+ cells between days 14 and 28 tended to be better in the GVHD group. In conclusion, L-index(30) was significantly associated with CMV reactivation and grade II-IV acute GVHD, but its clinical significance seemed to differ according to the results of a lymphocyte subset analysis.

我们前瞻性地验证了先前报道的L指数，该指数反映了淋巴细胞减少的强度和持续时间，并在同种异体造血干细胞移植（HSCT）后使用淋巴细胞亚组分析对其进行了进一步评估（n = 30）。L指数定义为淋巴细胞减少期间（<700 /μl）淋巴细胞曲线上的面积，并从开始调节至第30天（L-index（30））和第100天（L-index（100））进行计算。在HSCT之前和之后的14、21、28、42、56、70和84天分析了包括CD3，CD4，CD8，CD19和CD56在内的淋巴细胞亚群。通过C10 / 11方法在21例（CMV-AG≥3组）中位34天时检测到巨细胞病毒（CMV）抗原血症为> 3个细胞/ 2张玻片。CMV-AG≥3组的L指数（30）显着高于CMV-AG <3组（中位数20,358 vs 17,235，P = .028）。在CMV-AG≥3组中，HSCT受损后第14天到28天之间CD4 +和CD56 +细胞计数的恢复。关于移植物抗宿主病（GVHD），在14位患者（GVHD组）中，中位31天被鉴定为II-IV级急性GVHD。GVHD组的L指数（30）显着降低（中位数19,048比22,256，P  = .043）。GVHD组在第14天到第28天之间恢复CD3 +细胞（包括CD4 +和CD8 +细胞）的趋势往往更好。总之，L-指数（30）与CMV激活和II-IV级急性GVHD显着相关，但根据淋巴细胞亚群分析的结果，其临床意义似乎有所不同。