التفاصيل البيبلوغرافية
| العنوان: |
Early immune reconstitution as predictor for outcomes after allogeneic hematopoietic cell transplant; a tri-institutional analysis |
| المؤلفون: |
Troullioud Lucas, Alexandre G, Lindemans, Caroline A, Bhoopalan, Senthil Velan, Dandis, Rana, Prockop, Susan E, Naik, Swati, Keerthi, Dinesh, de Koning, Coco, Sharma, Akshay, Nierkens, Stefan, Boelens, Jaap Jan |
| المساهمون: |
SCT patientenzorg, Child Health, Infection & Immunity, Regenerative Medicine and Stem Cells, CTI Nierkens, Cancer, CTI Research |
| سنة النشر: |
2023 |
| مصطلحات موضوعية: |
Child, Graft vs Host Disease/etiology, Hematologic Neoplasms/therapy, Hematopoietic Stem Cell Transplantation/methods, Humans, Immune Reconstitution, Leukemia, Myeloid, Acute, Retrospective Studies, Transplantation, Homologous, Young Adult, non-relapse mortality, relapse, GVHD, hematologic malignancies, allogeneic hematopoietic cell transplant, Genetics(clinical), Oncology, Cancer Research, Immunology and Allergy, Cell Biology, Immunology, Journal Article, Research Support, N.I.H., Extramural |
| الوصف: |
Background aims: CD4 immune reconstitution (IR) after allogeneic hematopoietic cell transplant (allo-HCT) correlates with lower non-relapse mortality (NRM), but its impact on leukemia relapse remains less clear, especially in children. We studied the correlation between IR of lymphocyte subsets and HCT outcomes in a large cohort of children/young adults with hematological malignancies. Methods: We retrospectively analyzed CD4, CD8, B-cell and natural killer (NK) cell reconstitution in patients after first allo-HCT for a hematological malignancy at three large academic institutions (n = 503; period 2008–2019). We used Cox proportional hazard and Fine–Gray competing risk models, martingale residual plots and maximally selected log-rank statistics to assess the impact of IR on outcomes. Results: Achieving CD4 >50 and/or B cells >25 cells/μL before day 100 after allo-HCT was a predictor of lower NRM (CD4 IR: hazard ratio [HR] 0.26, 95% confidence interval [CI] 0.11–0.62, P = 0.002; CD4 and B cell IR: HR 0.06, 95% CI 0.03–0.16, P < 0.001), acute graft-versus-host disease (GVHD) (CD4 and B cell IR: HR 0.02, 95% CI 0.01–0.04, P < 0.001) and chronic GVHD (CD4 and B cell IR: HR 0.16, 95% CI 0.05–0.49, P = 0.001) in the full cohort, and of lower risk of relapse (CD4 and B cell IR: HR 0.24, 95% CI 0.06–0.92, P = 0.038) in the acute myeloid leukemia subgroup. No correlation between CD8 and NK-cell IR and relapse or NRM was found. Conclusions: CD4 and B-cell IR was associated with clinically significant lower NRM, GVHD and, in patients with acute myeloid leukemia, disease relapse. CD8 and NK-cell IR was neither associated with relapse nor NRM. If confirmed in other cohorts, these results can be easily implemented for risk stratification and clinical decision making. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| تدمد: |
1465-3249 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/451973 |
| الاتاحة: |
https://dspace.library.uu.nl/handle/1874/451973 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: |
edsbas.908C7885 |
| قاعدة البيانات: |
BASE |
Full Text Finder