Rapid helper T-cell recovery above 200 x 10 6/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation.
The current study evaluates the role of quantitative measurement of peripheral lymphocyte subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell transplantation. A total of 69 allogeneic recipients were included with following diagnoses: acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15, non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral lymphocyte subset counts (CD3+ T cells, CD3+4+ helper T cells, CD3+8+ cytotoxic T cells, CD19+ B cells, and CD56+ natural killer cells) were measured at 3, 6 and 12 months. The CD4+ helper T-cell reconstitution at 3 months was strongly correlated with OS (P<0.0001), NRM (P=0.0007), and opportunistic infections (P=0.0108) at the cutoff value of 200 x 10(6)/l CD4(+) helper T cells. Rapid CD4+ helper T-cell recovery was also associated with a higher CD4+ helper T-cell transplant dose (P=0.006) and donor type (P<0.001). An early CD4+ helper T-cell recovery at 3 months correlated with a subsequent faster helper T-cell recovery until 12 months, yet not with B-cell recovery. In a multivariate analysis, rapid recovery of CD4+ helper T cells at 3 months was a favorable prognostic factor together with higher CD34+ cell transplant dose in terms of OS (P=0.001) and NRM (P=0.005).
Kim
D H
DH
Department of Hematology/Oncology, Kyungpook National University Hospital, 50 Samduk 2-ga, Jung-Gu, Daegu 700-721, Korea.
Sohn
S K
SK
Won
D I
DI
Lee
N Y
NY
Suh
J S
JS
Lee
K B
KB
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000097:blood; D001402:B-Lymphocytes; D001782:Blood Donors; D015496:CD4-Positive T-Lymphocytes / Q000637:transplantation; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D018655:Lymphocyte Count; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood / Q000209:etiology; D020127:Recovery of Function; D033581:Stem Cell Transplantation / Q000401:mortality; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D015703:Antigens, CD