Rapid helper T-cell recovery above 200× 106/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation

DH Kim, SK Sohn, DI Won, NY Lee, JS Suh… - Bone marrow …, 2006 - nature.com
DH Kim, SK Sohn, DI Won, NY Lee, JS Suh, KB Lee
Bone marrow transplantation, 2006nature.com
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 …
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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