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Early recovery of T-cell function predicts improved survival after T-cell depleted allogeneic transplant

2017; Taylor & Francis; Volume: 58; Issue: 8 Linguagem: Inglês

10.1080/10428194.2016.1265113

1042-8194

Jenna D. Goldberg, Junting Zheng, Ravin Ratan, Trudy N. Small, Kuan-Chi Lai, Farid Boulad, Hugo Castro‐Malaspina, Sergio Giralt, Ann A. Jakubowski, Nancy A. Kernan, Richard J. O’Reilly, Esperanza B. Papadopoulos, James W. Young, Marcel R.M. van den Brink, Glenn Heller, Miguel‐Angel Perales,

T-cell and B-cell Immunology

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.