title: Association between thymic function and allogeneic hematopoietic stem cell transplantation outcome: results of a pediatric study.
abstract: Robust T cell function recovery has been shown to be crucial in determining allogeneic hematopoietic stem cell transplantation (HSCT) outcome, and there is growing evidence that the thymus plays a central role in regulating this process. We performed a long-term analysis of the role of thymic activity recovery in a population of pediatric patients undergoing allogeneic HSCT by signal joint T cell receptor excision circle (sjTREC) quantification. In this study, characterized by a long-term follow-up (median, 72 months), we found patients with higher levels of sjTRECs before transplantation had a statistically significant reduced risk of death compared with patients with lower values (relative risk, .31; 95% confidence interval, .30 to .32; P = .02), showing this different outcome was mainly related to a reduction of relapse incidence (14% versus 43%, P = .02). Unlike previous reports, we observed no correlation between sjTREC levels and lymphocyte recovery. Moreover, we confirmed that only graft-versus-host disease influenced thymic activity after transplantation. In conclusion, our results suggest an association between pretransplantation thymic activity and the long-term outcome of pediatric patients undergoing HSCT, mainly through a reduction of relapse opportunities.
authors.affiliation: Pediatric Onco-Hematology, Stem Cell Transplantation, and Cellular Therapy Division, A.O.U. Citta' della Salute e della Scienza di Torino, Ospedale Infantile Regina Margherita, Torino, Italy. Electronic address: francesco.saglio@hotmail.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Saglio
authors.affiliation: Division of Hematology, A.O.U. Citta' della Salute e della Scienza di Torino, Presidio Molinette, University of Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Cena
authors.affiliation: Pediatric Onco-Hematology, Stem Cell Transplantation, and Cellular Therapy Division, A.O.U. Citta' della Salute e della Scienza di Torino, Ospedale Infantile Regina Margherita, Torino, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Berger
authors.affiliation: Pediatric Onco-Hematology, Stem Cell Transplantation, and Cellular Therapy Division, A.O.U. Citta' della Salute e della Scienza di Torino, Ospedale Infantile Regina Margherita, Torino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Quarello
authors.affiliation: Division of Hematology, A.O.U. Citta' della Salute e della Scienza di Torino, Presidio Molinette, University of Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
authors.forename: Viola
authors.initials: V
authors.lastname: Boccasavia
authors.affiliation: Division of Hematology, A.O.U. Citta' della Salute e della Scienza di Torino, Presidio Molinette, University of Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ferrando
authors.affiliation: Pediatric Onco-Hematology, Stem Cell Transplantation, and Cellular Therapy Division, A.O.U. Citta' della Salute e della Scienza di Torino, Ospedale Infantile Regina Margherita, Torino, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pittana
authors.affiliation: Division of Hematology, A.O.U. Citta' della Salute e della Scienza di Torino, Presidio Molinette, University of Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Bruno
authors.affiliation: Pediatric Onco-Hematology, Stem Cell Transplantation, and Cellular Therapy Division, A.O.U. Citta' della Salute e della Scienza di Torino, Ospedale Infantile Regina Margherita, Torino, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Fagioli
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019653:Myeloablative Agonists / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000032:analysis / Q000276:immunology; D012008:Recurrence; D035781:Siblings; D016019:Survival Analysis; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology; D013950:Thymus Gland / Q000276:immunology / Q000473:pathology*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D019653:Myeloablative Agonists; D016693:Receptors, Antigen, T-Cell, alpha-beta
keywords: Allogeneic hematopoietic stem cell transplantation; Pediatric; sjTREC