Post-transplant immune reconstitution after unrelated allogeneic stem cell transplant in patients with acute myeloid leukemia.

Publisher: Taylor & Francis Country of Publication: United States NLM ID: 9007422 Publication Model: Print Cited Medium: Internet ISSN: 1029-2403 (Electronic) Linking ISSN: 10268022 NLM ISO Abbreviation: Leuk Lymphoma Subsets: MEDLINE

Publication: [Philadelphia, PA] : Taylor & Francis
Original Publication: Chur ; New York : London, UK : Harwood Academic Publishers ; Distributed by STBS, 1989-

Hematopoietic Stem Cell Transplantation*; Immune System/*immunology ; Leukemia, Myeloid, Acute/*immunology ; Leukemia, Myeloid, Acute/*therapy ; Lymphocyte Subsets/*immunology; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Graft vs Host Disease/immunology ; Humans ; Immune System/cytology ; Immunophenotyping ; Infant ; Killer Cells, Natural/immunology ; Leukemia, Myeloid, Acute/pathology ; Lymphocyte Subsets/cytology ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/therapy ; Remission Induction ; Retrospective Studies ; Salvage Therapy ; Survival Rate ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome ; Young Adult

We evaluated immune recovery in 67 patients with acute myeloid leukemia (AML) with a median age of 40 years (4-69) following allo-SCT after reduced (n = 35) or myeloablative (n = 32) conditioning. The following lymphocyte populations were determined on days +30, +90, +180, +270, and +365 by flow associated cell sorting: CD3+, CD3+CD4+, CD3+CD8+, CD3+CD4+/CD3+CD8+ ratio, CD3-CD56+, and CD19+ cells. Peripheral blast count >5% was related to lower number of CD3+CD4+ (day +30) and NK cells (day +180; p = 0.02). Intensity of conditioning did not have any significant impact on the kinetics of immune recovery. Patients with normal CD3+CD4+/CD3+CD8+ ratio (day +30) and NK cell count (day +90; p <0.05) experienced better survival than those with decreased parameters. Post-transplant sepsis/severe infections impaired CD3+CD8+ (day +90; p = 0.015) and CD19+ (day +90; p = 0.02) recovery. Relapse in patients following allo-SCT showed an association with decreased numbers of CD19+ (day +270) and NK cells (day +365). Acute GvHD (II-IV) was accompanied by reduced CD19+ and CD3+CD4+ cells. Thus, the evaluation of post-transplant immune reconstitution in patients with AML might improve risk stratification concerning either relapse or TRM and remains to be further explored.

Date Created: 20100619 Date Completed: 20101116 Latest Revision: 20190116

20231215

10.3109/10428194.2010.496015

20557144