부산대학교 도서관

In this single-center study we retrospectively evaluated the impact of early reconstitution of different lymphocyte subsets on patient outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We found that CD8.sup.+ T-cell counts exceeding 50x10.sup.6 /l as early as on day 28 post-transplantation correlated significantly with decreased relapse risk, with three-year relapse rates of 17.0% and 55.6% (P = 0.002), but were also associated with severe acute and chronic GVHD. Incidence of grade III-IV acute GVHD was 30.5% for those with early CD8.sup.+ T-cell recovery compared to 2.1% for those with lower CD8.sup.+ T-cell counts on day 28 post-transplant (HR = 20.24, P = 0.004). Early CD8.sup.+ T-cell reconstitution did not, however, affect the overall survival. Multivariate analysis showed that slow CD8.sup.+ T-cell reconstitution was strongly associated with increased risk of relapse (HR = 3.44, P = 0.026). A weaker correlation was found between CD4.sup.+ reconstitution and relapse-risk, but there was no such association with CD19.sup.+ B-cells or NK-cells. In conclusion, the early CD8.sup.+ T-cell recovery on day 28 post-transplant is associated with the lower risk of relapse but also predicts the impending severe GVHD, and thus could be useful in guiding timely treatment decisions.
Author(s): Juha Ranti 1,*, Samu Kurki 2, Urpu Salmenniemi 1, Mervi Putkonen 1, Soile Salomäki 1, Maija Itälä-Remes 1 Introduction Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an intensive treatment [...]