Multivariate analyses of immune reconstitution in children after allo-SCT: risk-estimation based on age-matched leukocyte sub-populations.
The speed of immune recovery after allo-SCT is of central importance to overcome infectious complications and relapse. To evaluate the immune reconstitution of pediatric patients concerning overall survival, we developed a three-component multivariate model and generated a reference domain of ellipsoidal shape on the basis of normal leukocyte subtype values of 100 healthy children and adolescents. The leukocyte subtypes include absolute nos. of leukocytes, CD14(+) monocytes, lymphocytes, CD3(+) T cells, CD3(+)CD4(+) helper T cells, CD3(+)CD8(+) cytotoxic T cells, CD3(-)CD56(+) natural killer-cells and CD19(+) B cells, all of which are correlated, thus, requiring the application of multivariate as opposed to multiple univariate modeling. According to their immune reconstitution, 32 pediatric patients post allo-SCT were classified into low-risk and high-risk groups on the basis of our new model. Therefore, we evaluated if the patients reached the ellipsoid of normal leukocyte sub-population values post SCT. We detected a significantly higher number of long-time survivors among the low-risk group compared with the high-risk group at days 200 (P=0.001) and 300 (P<0.0001). This is superior to our previously published univariate analysis. Combined with the clinical observation, a classification into risk groups based on an extended patient cohort may represent a predictor for complications.
Koenig
M
M
Pediatric Hematology and Oncology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
Huenecke
S
S
Salzmann-Manrique
E
E
Esser
R
R
Quaritsch
R
R
Steinhilber
D
D
Radeke
H H
HH
Martin
H
H
Bader
P
P
Klingebiel
T
T
Schwabe
D
D
Schneider
G
G
Lehrnbecher
T
T
Orth
A
A
Koehl
U
U
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007111:Immunity, Cellular; D007694:Killer Cells, Natural; D018655:Lymphocyte Count; D008297:Male; D009000:Monocytes; D015999:Multivariate Analysis; D012016:Reference Values; D018570:Risk Assessment; D016019:Survival Analysis; D016176:T-Lymphocyte Subsets; D014184:Transplantation, Homologous; D055815:Young Adult