Helper T cells (CD3 + /CD4 + ) within the autologous peripheral blood stem cell graft positively correlate with event free survival of multiple myeloma patients.
BACKGROUND
The microenvironment in the bone marrow - including lymphocytes - is part of the pathophysiology of multiple myeloma (MM). High dose chemotherapy followed by autologous stem cell transplantation is standard of care for younger patients.


OBJECTIVE
To determine the influence of reinfused lymphocyte subsets on event free survival (EFS) and overall survival (OS).


METHODS
In peripheral blood (PB) and aphaeresis products (AP) of 41 MM patients lymphocyte subsets were determined by flow cytometry and were correlated with clinical outcome.


RESULTS
PB lymphocyte subsets did not influence EFS or OS. Residual plasma cells in the AP were not correlated with poor outcome, whereas a high percentage of B cells (CD19+) showed a trend towards reduced EFS (P = 0.051). A high amount of CD4 cells and an increased CD4/CD8 ratio were significantly associated with prolonged EFS. In contrast, high percentage of HLA-DR positive lymphocytes showed negative impact on EFS and OS (P = 0.03 and 0.02, respectively).


CONCLUSIONS
Obtained data suggest the non-activated (HLA-DR negative) helper CD4+ T cells in the AP to be tumour protective.
Schmidmaier
R
R
Department of Hematology and Oncology, Medizinische Klinik Innenstadt, Klinikum der Universitat Munchen, Munich, Germany. ralf.schmidmaier@med.uni-muenchen.de
Oversohl
N
N
Schnabel
B
B
Straka
C
C
Emmerich
B
B
D000328:Adult; D000368:Aged; D017252:CD3 Complex / Q000276:immunology*; D015704:CD4 Antigens / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D006086:Graft vs Host Disease / Q000517:prevention & control; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D015996:Survival Rate; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D014182:Transplantation, Autologous
D017252:CD3 Complex; D015704:CD4 Antigens; D006684:HLA-DR Antigens