1. 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
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Bondanza A, Ruggeri L, Noviello M, Eikema DJ, Bonini C, Chabannon C, van der Werf S, van Biezen A, de Wreede LC, Crucitti L, Vago L, Merluzzi M, Massei MS, Veelken H, Koc Y, Bader P, Gruhn B, Locatelli F, Ciceri F, Toubert A, and Velardi A
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Leukemia, Male, Middle Aged, Registries, Risk Factors, Young Adult, CD8-Positive T-Lymphocytes metabolism, Stem Cell Transplantation methods, Transplantation, Haploidentical methods
- 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
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