title: Early recovery of T-cell function predicts improved survival after T-cell depleted allogeneic transplant.
abstract: Infection, relapse, and GVHD can complicate allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although the effect of poor immune recovery on infection risk is well-established, there are limited data on the effect of immune reconstitution on relapse and survival, especially following T-cell depletion (TCD). To characterize the pattern of immune reconstitution in the first year after transplant and its effects on survival and relapse, we performed a retrospective study in 375 recipients of a myeloablative TCD allo-HSCT for hematologic malignancies. We noted that different subsets recover sequentially, CD8 + T cells first, followed by total CD4 + and naïve CD4 + T cells, indicating thymic recovery during the first year after HSCT. In the multivariate model, a fully HLA-matched donor and recovery of T-cell function, assessed by PHA response at 6 months, were the only factors independently associated with OS and EFS. In conclusion, T-cell recovery is an important predictor of outcome after TCD allo-HSCT.
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Jenna D
authors.initials: JD
authors.lastname: Goldberg
authors.affiliation: c Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Junting
authors.initials: J
authors.lastname: Zheng
authors.affiliation: b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Ravin
authors.initials: R
authors.lastname: Ratan
authors.affiliation: b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.|d Department of Pediatrics, Bone Marrow Transplantation Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Trudy N
authors.initials: TN
authors.lastname: Small
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Kuan-Chi
authors.initials: KC
authors.lastname: Lai
authors.affiliation: b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.|d Department of Pediatrics, Bone Marrow Transplantation Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Farid
authors.initials: F
authors.lastname: Boulad
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Hugo
authors.initials: H
authors.lastname: Castro-Malaspina
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Ann A
authors.initials: AA
authors.lastname: Jakubowski
authors.affiliation: b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.|d Department of Pediatrics, Bone Marrow Transplantation Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Kernan
authors.affiliation: b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.|d Department of Pediatrics, Bone Marrow Transplantation Service , Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Reilly
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Esperanza B
authors.initials: EB
authors.lastname: Papadopoulos
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Young
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Marcel R M
authors.initials: MR
authors.lastname: van den Brink
authors.affiliation: b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.|c Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center , New York , NY , USA.
authors.forename: Glenn
authors.initials: G
authors.lastname: Heller
authors.affiliation: a Department of Medicine , Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center , New York , NY , USA.|b Department of Medicine , Weill Cornell Medical College , New York , NY , USA.
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Perales
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007111:Immunity, Cellular; D016130:Immunophenotyping; D018655:Lymphocyte Count; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology* / Q000378:metabolism*; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Immune reconstitution; T-cell depletion; allogeneic hematopoietic stem cell transplant