Beneficial role of CD8+ T-cell reconstitution after HLA-haploidentical stem cell transplantation for high-risk acute leukaemias: results from a clinico-biological EBMT registry study mostly in the T-cell-depleted setting: Bone Marrow Transplantation

A Bondanza, L Ruggeri, M Noviello, DJ Eikema, C Bonini, C Chabannon, S van der Werf, A van Biezen, LC de Wreede, L Crucitti, L Vago, M Merluzzi, MS Massei, H Veelken, Y Koc, P Bader, B Gruhn, F Locatelli, F Ciceri, A ToubertA Velardi, on behalf of the EBMT Cell Therapy, Immunobiology Working Party

Research output: Contribution to journalArticlepeer-review

Abstract

HLA-haploidentical haematopoietic stem cell transplantation (haplo-HSCT) is increasingly offered to patients with high-risk acute leukaemia. Unfortunately, haplo-HSCT is followed by a delayed immunoreconstitution. The aim of this EBMT registry study was to explore the clinical impact of lymphocyte subset counts after haplo-HSCT. We considered 144 leukaemic patients transplanted in the period 2001–2012. Pre-transplantation clinical variables and differential immune-cell counts (CD3, CD4, CD8 T cells, NK and B cells) measured before day 100 were evaluated for their capacity to predict overall survival, relapse mortality or non-relapse mortality (NRM). Negative prognostic factors for overall survival were advanced disease state at transplantation, host age and CMV seropositivity. Higher CD3, CD4 and CD8 counts were associated with a better overall survival and a lower NRM. Strikingly, when tested in multivariable analysis, higher CD3 and CD8 counts were still significantly associated with a lower NRM. These results indicate that an accelerated T-cell reconstitution correlates with less transplantation mortality, likely due to the protective role of T cells against viral infections. This observation suggests that CD8+ T-cell counts should be investigated as surrogate biomarkers of outcome in prospective haplo-HSCT trials. © 2018, Springer Nature Limited.
Original languageEnglish
Pages (from-to)54(6)
JournalBone Marrow Transplantation
Volume54
Issue number6
DOIs
Publication statusPublished - 2019

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