1. Early Natural Killer Cell Reconstitution Predicts Overall Survival in T Cell-Replete Allogeneic Hematopoietic Stem Cell Transplantation.
- Author
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Minculescu L, Marquart HV, Friis LS, Petersen SL, Schiødt I, Ryder LP, Andersen NS, and Sengeloev H
- Subjects
- Adolescent, Adult, Aged, Allografts, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Infections etiology, Leukemia, Myeloid, Acute complications, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute therapy, Lymphocyte Count, Male, Middle Aged, Myelodysplastic Syndromes complications, Myelodysplastic Syndromes therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma complications, Precursor Cell Lymphoblastic Leukemia-Lymphoma mortality, Prognosis, Survival Rate, Young Adult, Hematopoietic Stem Cell Transplantation mortality, Killer Cells, Natural cytology
- Abstract
Early immune reconstitution plays a critical role in clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT). Natural killer (NK) cells are the first lymphocytes to recover after transplantation and are considered powerful effector cells in HSCT. We aimed to evaluate the clinical impact of early NK cell recovery in T cell-replete transplant recipients. Immune reconstitution was studied in 298 adult patients undergoing HSCT for acute myeloid leukemia, acute lymphoblastic leukemia, and myelodysplastic syndrome from 2005 to 2013. In multivariate analysis NK cell numbers on day 30 (NK30) > 150 cells/µL were independently associated with superior overall survival (hazard ratio, .79; 95% confidence interval, .66 to .95; P = .01). Cumulative incidence analyses showed that patients with NK30 > 150 cells/µL had significantly less transplant-related mortality (TRM), P = .01. Patients with NK30 > 150 cells/µL experienced significantly lower numbers of life-threatening bacterial infections as well as viral infections, including cytomegalovirus. No association was observed in relation to relapse. These results suggest an independent protective effect of high early NK cell reconstitution on TRM that translates into improved overall survival after T cell-replete HSCT., (Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2016
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