Rapid helper T-cell recovery above 200× 106/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation
The current study evaluates the role of quantitative measurement of peripheral lymphocyte
subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including
overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell
transplantation. A total of 69 allogeneic recipients were included with following diagnoses:
acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15,
non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral …
subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including
overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell
transplantation. A total of 69 allogeneic recipients were included with following diagnoses:
acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15,
non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral …
Abstract
The current study evaluates the role of quantitative measurement of peripheral lymphocyte subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell transplantation. A total of 69 allogeneic recipients were included with following diagnoses: acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15, non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral lymphocyte subset counts (CD3+ T cells, CD3+ 4+ helper T cells, CD3+ 8+ cytotoxic T cells, CD19+ B cells, and CD56+ natural killer cells) were measured at 3, 6 and 12 months. The CD4+ helper T-cell reconstitution at 3 months was strongly correlated with OS (P< 0.0001), NRM (P= 0.0007), and opportunistic infections (P= 0.0108) at the cutoff value of 200× 10 6/l CD4+ helper T cells. Rapid CD4+ helper T-cell recovery was also associated with a higher CD4+ helper T-cell transplant dose (P= 0.006) and donor type (P< 0.001). An early CD4+ helper T-cell recovery at 3 months correlated with a subsequent faster helper T-cell recovery until 12 months, yet not with B-cell recovery. In a multivariate analysis, rapid recovery of CD4+ helper T cells at 3 months was a favorable prognostic factor together with higher CD34+ cell transplant dose in terms of OS (P= 0.001) and NRM (P= 0.005).
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