1. ¹Department of Internal Medicine, Division of Hematology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
2. ²Department of Pathology, Kawasaki Medical School, Okayama, Japan
3. ³Department of Pathology, Okayama University Graduate School of Medical and Dental Sciences, Okayama, Japan
4. ⁴Department of Anesthesiology, Okayama University Graduate School of Medical and Dental Sciences, Okayama, Japan
5. ⁵Department of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

Correspondence: Dr J Tsuchiyama, Department of Pathology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. E-mail: j-tutti@nifty.com

Received 14 July 2008; Revised 16 September 2008; Accepted 17 September 2008; Published online 1 December 2008.

Abstract

Acute GVHD (aGVHD) is a serious complication after allogeneic SCT (allo-SCT). However, an adequate immunological index is not yet available for assessing its severity. We analyzed the fraction of cutaneous lymphocyte antigen (CLA)⁺ cells in peripheral blood T and natural killer (NK) cells in 33 patients and evaluated its association with aGVHD. The CLA⁺ T-cell fraction often increased 3–7 days before the onset of aGVHD, and the maximum percentage of CLA⁺ T cells in grades II–IV aGVHD cases was significantly higher than that in grade 0 or I aGVHD (P<0.01). When the cutoff value of the maximum CLA⁺ T-cell percentage was set at 20%, any higher percentage was a significant risk for the development of severe aGVHD (P<0.0001). The maximum CLA⁺ T-cell percentage was significantly correlated with a high body temperature, low percutaneous oxygen saturation, and fibrinogen/fibrin degradation product D-dimer level. The post-allo-SCT CLA⁺ T cells exhibited a high ability to produce IL-2 and IFN-, and may be the effectors and immunological markers for aGVHD. The CLA⁺ NK-cell-fraction steadily increased 2–4 weeks after allo-SCT but was not influenced by aGVHD. The CLA⁺ T-cell percentage may predict the development of severe aGVHD in clinical settings.