title: Lymphocyte subset recovery and outcome after autologous hematopoietic stem cell transplantation for plasma cell myeloma.
abstract: Rapid immune reconstitution--particularly of natural killer cells (NK cells)--after allogeneic hematopoietic stem cell transplantation (HSCT) is associated with protection from relapse. Whether such an association also exists after autologous stem cell transplantation is less clear. We retrospectively assessed lymphocyte subsets after autologous HSCT in 114 patients and correlated lymphocyte recovery with outcome. CD8 T cell and NK cell counts recovered rapidly to pretransplantation levels, whereas B cell and CD4 T cell recovery were delayed. Compared with patients with low NK cells (<100/uL), high NK cell count at 1 month after HSCT was associated with significantly prolonged progression-free survival: for NK cells 100 to 200/uL hazard ratio [HR], .33 (95% confidence interval [CI]; .16 to .80; P = .004); for NK cells > 200/μL HR, .27 (95% CI, .13 to .58; P = .001). No significant protective effects were associated with rapid recovery of any other lymphocyte subset. None influenced overall survival (OS) or time to next treatment. Early NK cell recovery is associated with better progression-free survival after autologous HSCT. The failure to detect an effect on OS might be due to the salvage strategies available to these patients.
authors.affiliation: Division of Hematology, University Hospital, Basel, Switzerland.
authors.forename: Jessica
authors.initials: J
authors.lastname: Rueff
authors.affiliation: Division of Hematology, University Hospital, Basel, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Medinger
authors.affiliation: Division of Hematology, University Hospital, Basel, Switzerland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Heim
authors.affiliation: Division of Hematology, University Hospital, Basel, Switzerland.
authors.forename: Jakob
authors.initials: J
authors.lastname: Passweg
authors.affiliation: Division of Hematology, University Hospital, Basel, Switzerland. Electronic address: martin.stern@usb.ch.
authors.forename: Martin
authors.initials: M
authors.lastname: Stern
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000276:immunology* / Q000473:pathology; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous
keywords: Autologous stem cell transplantation; Natural killer cells; Plasma cell myeloma