title: Post-transplant immune reconstitution after unrelated allogeneic stem cell transplant in patients with acute myeloid leukemia.
abstract: We evaluated immune recovery in 67 patients with acute myeloid leukemia (AML) with a median age of 40 years (4-69) following allo-SCT after reduced (n = 35) or myeloablative (n = 32) conditioning. The following lymphocyte populations were determined on days +30, +90, +180, +270, and +365 by flow associated cell sorting: CD3+, CD3+CD4+, CD3+CD8+, CD3+CD4+/CD3+CD8+ ratio, CD3-CD56+, and CD19+ cells. Peripheral blast count >5% was related to lower number of CD3+CD4+ (day +30) and NK cells (day +180; p = 0.02). Intensity of conditioning did not have any significant impact on the kinetics of immune recovery. Patients with normal CD3+CD4+/CD3+CD8+ ratio (day +30) and NK cell count (day +90; p <0.05) experienced better survival than those with decreased parameters. Post-transplant sepsis/severe infections impaired CD3+CD8+ (day +90; p = 0.015) and CD19+ (day +90; p = 0.02) recovery. Relapse in patients following allo-SCT showed an association with decreased numbers of CD19+ (day +270) and NK cells (day +365). Acute GvHD (II-IV) was accompanied by reduced CD19+ and CD3+CD4+ cells. Thus, the evaluation of post-transplant immune reconstitution in patients with AML might improve risk stratification concerning either relapse or TRM and remains to be further explored.
authors.affiliation: Clinic for Stem Cell Transplantation, University Cancer Center Hamburg, Germany.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Klyuchnikov
authors.forename: Svetlana
authors.initials: S
authors.lastname: Asenova
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kern
authors.forename: Gökhan
authors.initials: G
authors.lastname: Kilinc
authors.forename: Francis
authors.initials: F
authors.lastname: Ayuk
authors.forename: Bettina
authors.initials: B
authors.lastname: Wiedemann
authors.forename: Michael
authors.initials: M
authors.lastname: Lioznov
authors.forename: Petra
authors.initials: P
authors.lastname: Freiberger
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Zalyalov
authors.forename: Axel Rolf
authors.initials: AR
authors.lastname: Zander
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bacher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007107:Immune System / Q000166:cytology / Q000276:immunology*; D016130:Immunophenotyping; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology; D015470:Leukemia, Myeloid, Acute / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D016131:Lymphocyte Subsets / Q000166:cytology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult