Predictive Role of Circulating Immune Cell Subtypes Early after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Acute Leukemia
- Author:
Tae Woo KIM
1
;
Sung Soo PARK
;
Ji Young LIM
;
Gi June MIN
;
Silvia PARK
;
Young Woo JEON
;
Seung Ah YAHNG
;
Seung Hwan SHIN
;
Sung Eun LEE
;
Jae Ho YOON
;
Byung Sik CHO
;
Ki Seong EOM
;
Seok LEE
;
Hee Je KIM
;
Chang Ki MIN
Author Information
- Publication Type:Original Article
- Keywords: Invariant NKT cells; Myeloid-derived suppressor cells; Acute leukemia; Graft-versus-host disease; Graft-versus-leukemia effect; Allogeneic hematopoietic stem cell transplantation
- MeSH: Biomarkers; Cohort Studies; Flow Cytometry; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Hematopoietic Stem Cells; Humans; Immunity, Innate; Incidence; Leukemia; Multivariate Analysis; Natural Killer T-Cells; Recurrence; T-Lymphocytes
- From:International Journal of Stem Cells 2019;12(1):73-83
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: Cells of innate immunity normally recover in the first weeks to months after allogenenic hematopoietic stem cell transplantation (allo-HSCT). Their relevance in terms of graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effect is largely unknown. The predictive role of early recovery in the immune cells on acute GVHD and GVL effect after allo-HSCT was investigated in patients with acute leukemia who achieved the first complete remission. METHODS: Peripheral blood samples were taken at the median of 14 days (range, 12~29 days) after allo-HSCT. A cohort including 119 samples and characteristics of patients were analyzed. Immune cell populations were identified by flow cytometry. RESULTS: The median age was 49.0 years (range, 21~69) at transplantation. Univariate analysis showed that age less than 40 years old, lower frequencies of CD8+ T cells, invariant natural killer T (iNKT) cells, monocytic myeloid derived suppressor cells (M-MDSCs) and higher frequency of immature MDSCs were associated with occurrence of grade III–IV acute GVHD. Multivariate analyses showed that iNKT cells (hazard ratio (HR), 0.453, 95% CI, 0.091~0.844, p=0.024) and M-MDSCs (HR, 0.271, 95% CI, 0.078~0.937, p=0.039) were independent factors. Combination of higher frequencies of both cell subsets was associated with lower incidence of grade III–IV acute GVHD, whereas patients with lower frequency of iNKT cells and higher frequency of M-MDSCs showed significant higher probability of relapse. CONCLUSIONS: iNKT cells and M-MDSCs could be relevant cell biomarkers for predicting acute GVHD and/or relapse in acute leukemia patients treated with allo-HSCT.
