1. Beneficial role of CD8+T-cell reconstitution after HLA-haploidentical stem cell transplantation for high-risk acute leukaemias
- Author
-
Bondanza, A., Ruggeri, L., Noviello, M., Eikema, D.J., Bonini, C., Chabannon, C., Werf, S. van der, Biezen, A. van, Wreede, L.C. de, Crucitti, L., Vago, L., Merluzzi, M., Massei, M.S., Veelken, H., Koc, Y., Bader, P., Gruhn, B., Locatelli, F., Ciceri, F., Toubert, A., Velardi, A., Bernardo, M.E., Dazzi, F., Ellard, R., Fleischhauer, K., Greco, R., Hudecek, M., Kohl, U., Kuball, J., Malard, F., Pedrazzoli, P., Rocha, V., Ruggeri, A., Urbano-Ispizua, A., Wang, J.F., Wieten, L., EBMT Cell Therapy Immunobiol Worki, Bondanza, Attilio, Ruggeri, Loredana, Noviello, Maddalena, Eikema, Dirk-Jan, Bonini, Chiara, Chabannon, Christian, van der Werf, Steffie, van Biezen, Anja, de Wreede, Liesbeth C., Crucitti, Lara, Vago, Luca, Merluzzi, Mara, Massei, Maria Speranza, Veelken, Hendrik, Koc, Yener, Bader, Peter, Gruhn, Bernd, Locatelli, Franco, Ciceri, Fabio, Toubert, Antoine, Velardi, Andrea, MUMC+: DA TI Laboratorium (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, and MUMC+: DA TI Staf (9)
- Subjects
Male ,Oncology ,BLOOD ,COUNT ,Medizin ,CHILDREN ,CD8-Positive T-Lymphocytes ,DISEASE ,0302 clinical medicine ,Risk Factors ,hemic and lymphatic diseases ,Cytotoxic T cell ,Registries ,Child ,INDEX ,Leukemia ,Hematology ,Middle Aged ,RECOVERY ,Haematopoiesis ,surgical procedures, operative ,medicine.anatomical_structure ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Transplantation ,Child, Preschool ,030220 oncology & carcinogenesis ,HSCT ,Female ,Stem cell ,Adult ,medicine.medical_specialty ,Adolescent ,T cell ,Human leukocyte antigen ,Young Adult ,03 medical and health sciences ,CD8-positive T-lymphocytes ,haematopoietic stem cell transplantation ,risk factors ,Internal medicine ,SCORE ,medicine ,Humans ,IMMUNOTHERAPY ,Aged ,business.industry ,ADULTS ,BONE-MARROW-TRANSPLANTATION ,Transplantation, Haploidentical ,business ,CD8 ,Stem Cell Transplantation ,030215 immunology ,RESPONSES - 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.
- Published
- 2019
- Full Text
- View/download PDF