title: T Cell Receptor Excision Circle (TREC) Monitoring after Allogeneic Stem Cell Transplantation; a Predictive Marker for Complications and Clinical Outcome.
abstract: Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established treatment modality for a variety of malignant diseases as well as for inborn errors of the metabolism or immune system. Regardless of disease origin, good clinical effects are dependent on proper immune reconstitution. T cells are responsible for both the beneficial graft-versus-leukemia (GVL) effect against malignant cells and protection against infections. The immune recovery of T cells relies initially on peripheral expansion of mature cells from the graft and later on the differentiation and maturation from donor-derived hematopoietic stem cells. The formation of new T cells occurs in the thymus and as a byproduct, T cell receptor excision circles (TRECs) are released upon rearrangement of the T cell receptor. Detection of TRECs by PCR is a reliable method for estimating the amount of newly formed T cells in the circulation and, indirectly, for estimating thymic function. Here, we discuss the role of TREC analysis in the prediction of clinical outcome after allogeneic HSCT. Due to the pivotal role of T cell reconstitution we propose that TREC analysis should be included as a key indicator in the post-HSCT follow-up.
authors.affiliation: Department of Oncology and Pathology, Karolinska Institutet, SE-141 86 Stockholm, Sweden. Ahmed.Gaballa@ki.se.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Gaballa
authors.affiliation: Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-141 86 Stockholm, Sweden. Mikael.Sundin@ki.se.|Pediatric Blood Disorders, Immunodeficiency and Stem Cell Transplantation, Astrid Lindgren Children's Hospital, Karolinska University Hospital, SE-141 86 Stockholm, Sweden. Mikael.Sundin@ki.se.
authors.forename: Mikael
authors.initials: M
authors.lastname: Sundin
authors.affiliation: Department of Oncology and Pathology, Karolinska Institutet, SE-141 86 Stockholm, Sweden. Arwen.Stikvoort@ki.se.
authors.forename: Arwen
authors.initials: A
authors.lastname: Stikvoort
authors.affiliation: Stem Cells and Regenerative Medicine Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, KSA-11461 Riyadh, Saudi Arabia. AbumareeM@ksau-hs.edu.sa.
authors.forename: Muhamed
authors.initials: M
authors.lastname: Abumaree
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, SE-141 86 Stockholm, Sweden. Mehmet.Uzunel@ki.se.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uzunel
authors.affiliation: Department of Oncology and Pathology, Karolinska Institutet, SE-141 86 Stockholm, Sweden. Darius.Sairafi@ki.se.
authors.forename: Darius
authors.initials: D
authors.lastname: Sairafi
authors.affiliation: Department of Oncology and Pathology, Karolinska Institutet, SE-141 86 Stockholm, Sweden. Michael.Uhlin@ki.se.|Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, SE-141 86 Stockholm, Sweden. Michael.Uhlin@ki.se.
authors.forename: Michael
authors.initials: M
authors.lastname: Uhlin
mesh_terms: D064591:Allografts; D015415:Biomarkers / Q000097:blood; D000066891:Critical Care Outcomes; D006086:Graft vs Host Disease / Q000175:diagnosis; D006801:Humans; D011948:Receptors, Antigen, T-Cell / Q000097:blood; D033581:Stem Cell Transplantation
chemical_list: D015415:Biomarkers; D011948:Receptors, Antigen, T-Cell
keywords: TREC; immune reconstitution; transplantation