Prediction of graft-versus-host disease by phenotypic analysis of early immune reconstitution after CD6-depleted allogeneic bone marrow transplantation

摘要: Graft-versus-host disease (GVHD) is a major cause of morbidity and mortality following allogeneic bone marrow transplantation (BMT). Because GVHD frequently refractory to treatment, the early identification high-risk patients could have significant clinical value. To identify such patients, we examined immunologic recovery in 136 with hematologic malignancies who received anti-T12 (CD6)-purged over 9-year period. The majority from HLA-matched sibling donors after ablation cyclophosphamide total body irradiation. No any immune suppressive medications for prophylaxis. fraction absolute numbers peripheral blood lymphocytes (PBL) expressing CD3, CD4, CD8, CD56 surface antigens were determined weekly by immunofluorescence analysis beginning 8 14 days (week 2) infusion. Results did or not subsequently develop post-BMT compared. Within 2 weeks infusion, developed grades 2–4 had significantly higher percentages CD8+ T cells lower CD56+ natural killer (NK) than individuals remained free GVHD. Thirty-five percent whose PBL greater 25% second posttransplant week GVHD, compared only 3% < = (odds ratio 37.8; 95% confidence interval [CI] 4.1 397). A subgroup at very high risk be identified based on combined frequency NK blood. Seventy-five 45% during 11% remaining 24.9; CI, 5.3 117.0). None 23 both less Our findings indicate that play an important role pathogenesis humans. Analysis reconstitution BMT useful predicting onset can help direct implementation treatment strategies before appearance manifestations. Such interventions may decrease associated ultimately improve overall survival.