Clinical significance of autoantibody expression in allogeneic stem-cell recipients.
BACKGROUND
The occurrence of autoantibodies has been reported in allogeneic stem-cell recipients, but the association of this occurrence with chronic graft-versus-host disease (cGVHD) or survival remains uncertain.


METHODS
A total of 121 consecutive patients who underwent allogeneic stem-cell transplantation from November 2001 to March 2008 and survived at least 3 months after transplantation were included in this study.


RESULTS
Forty-seven patients (38.8%) expressed at least one of various autoantibodies after transplantation. Antinuclear antibody was positive in 22 patients (18.2%), antidouble stranded DNA in seven (5.8%), antismooth muscle antibody in six (5%), rheumatoid factor in 17 (14.0%), and a positive Coombs test recorded for 12 patients (9.9%). cGVHD was more commonly diagnosed in the patients with autoantibody expression (61.7% vs. 43.2%, P=0.048). The patients expressing autoantibodies had a better 5-year overall survival than those without any autoantibody expression: 70.2% and 47.9% for the autoantibody-positive and autoantibody-negative patients, respectively (P=0.002). The cumulative incidence of relapse was 21.5% and 39.3% for the autoantibody-positive and autoantibody-negative patients, respectively (P=0.023). In particular, the patients expressing autoantibodies without cGVHD had a better overall survival (100%) than the patients in the other groups: 63.1% for the autoantibody- and cGVHD-positive patients, 59.6% for the autoantibody-negative and cGVHD-positive patients, and 36.6% for the autoantibody- and cGVHD-negative patients. The multivariate analysis identified autoantibody expression as a good prognostic factor regarding survival (hazard ratio=0.378, 95% confidence interval=0.185-0.775, P=0.008).


CONCLUSIONS
The occurrence of autoantibodies after allogeneic stem-cell transplantation was found to be related to cGVHD, and patients expressing autoantibodies had a better survival.
Moon
Joon-Ho
JH
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu 700-721, Korea.
Lee
Soo-Jung
SJ
Kim
Jong-Gwang
JG
Chae
Yee-Soo
YS
Kim
Shi-Nae
SN
Kang
Byung-Woog
BW
Suh
Jang-Soo
JS
Lee
Kun-Soo
KS
Sohn
Sang-Kyun
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D006085:Graft Survival / Q000276:immunology; D006086:Graft vs Host Disease / Q000175:diagnosis*; D006801:Humans; D007938:Leukemia / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000601:surgery; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous; D055815:Young Adult
D000974:Antibodies, Antinuclear; D001323:Autoantibodies