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Post-Transplant Events

Lymphocyte subset recovery and outcome after T-cell replete allogeneic hematopoietic SCT

Bone Marrow Transplantation volume 46, pages 1357–1362 (2011)Cite this article

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Abstract

Rapid recovery of lymphocytes after T-cell depleted hematopoietic SCT (HSCT) protects from relapse of myeloid malignancies. Whether lymphocyte reconstitution has a similar role after non-manipulated transplantation is controversial. We assessed numbers of CD4 and CD8 T-cells, natural killer (NK) cells and B-cells, before and 1, 3, 6, 12 and 24 months after T-cell replete transplantation in 345 patients. Lymphocyte subset counts up to 6 months post transplant had no effect on relapse. Elevated number of NK cells 12 months post transplant protected from relapse. As a novel finding, early recovery of NK cells was associated with significant protection from TRM already at the 3 and 6 months time points (P=0.03, P=0.02). In Cox multivariable models, patients with NK cells above 150/μL were significantly protected from TRM (hazard ratio (HR) 0.45, 95% confidence interval (95% CI) 0.21–0.95, P=0.03), an effect comparable in magnitude with that of carrying >200 CD4 T-cells/μL (HR 0.37, 95% CI 0.19–0.74, P=0.005). CD8 T-cell and B-cell recovery did not affect the rates of relapse or TRM. Early reconstitution of NK cells and CD4 T-cells in patients undergoing T-cell replete HSCT independently protected from TRM. Only a weak protection from disease relapse was noted for patients with high numbers of NK cells, and this occurred only late after transplantation.

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Acknowledgements

MS was supported by the Swiss National Science foundation (grant PP00P3_128461/1).

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Stem Cell Transplant Team, University Hospital, Basel, Switzerland

    L Bühlmann, A S Buser, N Cantoni, S Gerull, A Tichelli, A Gratwohl & M Stern

  2. Blood Bank, Basel, Switzerland

    A S Buser

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  1. L Bühlmann
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  2. A S Buser
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  3. N Cantoni
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  4. S Gerull
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  5. A Tichelli
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  6. A Gratwohl
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  7. M Stern
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Correspondence to M Stern.

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Bühlmann, L., Buser, A., Cantoni, N. et al. Lymphocyte subset recovery and outcome after T-cell replete allogeneic hematopoietic SCT. Bone Marrow Transplant 46, 1357–1362 (2011). https://doi.org/10.1038/bmt.2010.306

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