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Bone Marrow Transplant. 2018 Dec 7. doi: 10.1038/s41409-018-0351-x. [Epub ahead of print]

Beneficial role of CD8+ T-cell reconstitution after HLA-haploidentical stem cell transplantation for high-risk acute leukaemias: results from a clinico-biological EBMT registry study mostly in the T-cell-depleted setting.

Author information

1
San Raffaele University Hospital and Scientific Institute, Milan, Italy. attilio.bondanza@gmail.com.
2
Perugia General Hospital and University, Perugia, Italy.
3
San Raffaele University Hospital and Scientific Institute, Milan, Italy.
4
Leiden University Medical Center, Leiden, Netherlands.
5
Institut Paoli-Calmettes and Inserm CBT-1409, Marseille, France.
6
University of Milan, Milan, Italy.
7
Medical Park Hospitals, Antalya, Turkey.
8
University Hospital Frankfurt, Goethe University, Frankfurt/Main, Germany.
9
Jena University Hospital, Jena, Germany.
10
IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy.
11
University of Pavia, Pavia, Italy.
12
Hôpital Saint-Louis, Paris, France.

Abstract

HLA-haploidentical haematopoietic stem cell transplantation (haplo-HSCT) is increasingly offered to patients with high-risk acute leukaemia. Unfortunately, haplo-HSCT is followed by a delayed immunoreconstitution. The aim of this EBMT registry study was to explore the clinical impact of lymphocyte subset counts after haplo-HSCT. We considered 144 leukaemic patients transplanted in the period 2001-2012. Pre-transplantation clinical variables and differential immune-cell counts (CD3, CD4, CD8 T cells, NK and B cells) measured before day 100 were evaluated for their capacity to predict overall survival, relapse mortality or non-relapse mortality (NRM). Negative prognostic factors for overall survival were advanced disease state at transplantation, host age and CMV seropositivity. Higher CD3, CD4 and CD8 counts were associated with a better overall survival and a lower NRM. Strikingly, when tested in multivariable analysis, higher CD3 and CD8 counts were still significantly associated with a lower NRM. These results indicate that an accelerated T-cell reconstitution correlates with less transplantation mortality, likely due to the protective role of T cells against viral infections. This observation suggests that CD8+ T-cell counts should be investigated as surrogate biomarkers of outcome in prospective haplo-HSCT trials.

PMID:
30531916
DOI:
10.1038/s41409-018-0351-x

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