Lymphocyte subset analysis for the assessment of treatment-related complications after autologous stem cell transplantation in multiple myeloma.
OBJECTIVE
The aim of this study was to investigate the correlation between infused lymphocyte populations and lymphocyte subsets at engraftment, and the early clinical implications of lymphocyte subset recovery after autologous stem cell transplantation (ASCT) in multiple myeloma (MM).


METHODS
We examined the lymphocyte populations of infused autografts and the lymphocyte subsets of peripheral blood at engraftment from 50 patients using flow cytometry. Each subset was grouped as low (below median) and high (above median) to examine the correlation with mucositis of grade 3 or more and the occurrence of infections and cytomegalovirus (CMV) reactivation.


RESULTS
Using Spearman correlation coefficients, we found that cell doses of infused CD8(+) (P = 0.042) and CD19(+) cells (P = 0.044) were significantly associated with the absolute lymphocyte count (ALC) at engraftment. The dose of infused CD34(+) cells was not associated with the change of lymphocyte subsets except for an inverse correlation with CD4(+) cells (P = 0.006). After adjusting for potential variables in univariate analysis, multivariate analyzes revealed that the lower ratio of infused CD4(+) to CD8(+) cells (P = 0.030) was an independent factor for severe mucositis. Of lymphocyte subsets at engraftment, a higher frequency of CD3(+) (P = 0.024) and a lower frequency of CD56(+) (P = 0.020) were independent predictors for infections after engraftment. A higher frequency of CD8(+) cells (P = 0.041) and a lower ratio of CD4(+) to CD8(+) (P = 0.021) were independent predictors for CMV reactivation.


CONCLUSIONS
Our data suggest that lymphocyte subset analysis of infused autograft and peripheral blood at engraftment may provide new predictors for early complications after ASCT in patient with MM.
Sung-Eun
SE
Lee
Seung-Ah
SA
Yahng
Byung-Sik
BS
Cho
Ki-Seong
KS
Eom
Yoo-Jin
YJ
Kim
Hee-Je
HJ
Kim
Seok
S
Lee
Seok-Goo
SG
Cho
Dong-Wook
DW
Kim
Jong-Wook
JW
Lee
Woo-Sung
WS
Min
Chong-Won
CW
Park
Chang-Ki
CK
Min
D000328:Adult; D000368:Aged; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology* / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000009:adverse effects*