Early recovery of T-cell function predicts improved survival after T-cell depleted allogeneic transplant

Infection, relapse, and GVHD can complicate allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although the effect of poor immune recovery on infection risk is well-established, there are limited data on the effect of immune reconstitution on relapse and survival, especially following T...

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Bibliographic Details
Published in:Leukemia & lymphoma 2017-08, Vol.58 (8), p.1859-1871
Main Authors: Goldberg, Jenna D., Zheng, Junting, Ratan, Ravin, Small, Trudy N., Lai, Kuan-Chi, Boulad, Farid, Castro-Malaspina, Hugo, Giralt, Sergio A., Jakubowski, Ann A., Kernan, Nancy A., O'Reilly, Richard J., Papadopoulos, Esperanza B., Young, James W., van den Brink, Marcel R.M., Heller, Glenn, Perales, Miguel-Angel
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
allogeneic hematopoietic stem cell transplant
Child
Child, Preschool
Female
Hematologic Neoplasms - immunology
Hematologic Neoplasms - mortality
Hematologic Neoplasms - therapy
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic Stem Cell Transplantation - methods
Humans
Immune reconstitution
Immunity, Cellular
Immunophenotyping
Lymphocyte Count
Lymphocyte Depletion
Male
Middle Aged
Prognosis
Survival Analysis
T-cell depletion
T-Lymphocyte Subsets - immunology
T-Lymphocyte Subsets - metabolism
T-Lymphocytes - immunology
T-Lymphocytes - metabolism
Time Factors
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Young Adult
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Summary:Infection, relapse, and GVHD can complicate allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although the effect of poor immune recovery on infection risk is well-established, there are limited data on the effect of immune reconstitution on relapse and survival, especially following T-cell depletion (TCD). To characterize the pattern of immune reconstitution in the first year after transplant and its effects on survival and relapse, we performed a retrospective study in 375 recipients of a myeloablative TCD allo-HSCT for hematologic malignancies. We noted that different subsets recover sequentially, CD8 + T cells first, followed by total CD4 + and naïve CD4 + T cells, indicating thymic recovery during the first year after HSCT. In the multivariate model, a fully HLA-matched donor and recovery of T-cell function, assessed by PHA response at 6 months, were the only factors independently associated with OS and EFS. In conclusion, T-cell recovery is an important predictor of outcome after TCD allo-HSCT.
ISSN:1042-8194
1029-2403
DOI:10.1080/10428194.2016.1265113