Low T-Cell Responses to Mitogen Stimulation Predicts Poor Survival in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation.

摘要: Background Successful engraftment and reconstitution of the innate adaptive immune system are associated with improved outcomes in recipients allogeneic hematopoietic stem cell transplantation (HSCT). A clinically meaningful simple biomarker immunosuppression could potentially assist clinicians their decision-making. We aimed to determine relationship between T-cell production interferon gamma (IFN-γ) response phytohemagglutinin (PHA) clinical HSCT recipients. Methods prospective observational multicenter study 73 adult was conducted Melbourne, Australia. Eligible participants were >18 years at risk cytomegalovirus disease. responses PHA assessed 3, 6, 9, 12 months post-HSCT using commercial quantiferon-cytomegalovirus assay, which quantifies IFN-γ by ELISA following stimulation PHA. low defined as <0.5 IU/ml Results At 3 months post-HSCT, high (median 7.68 IU/ml) seen 63% 0.06 IU/ml) 37%. significantly severity acute graft versus host disease (AGVHD) (spearman r = -0.53, p < 0.001) correlated blood lymphocyte count r = 0.52, p < 0.001). Twelve month overall survival greater individuals compared [92 vs. 62%, respectively, Cox proportional hazard ratio (HR): 4.12 95% CI: 1.2-13.7, p = 0.02]. Non-relapse mortality (NRM) higher (competing regression HR 11.6 p = 0.02). In no AGVHD PHA, 12-month 100 80 52%, respectively (log rank test p < 0.0001). Conclusion Low 3-month time-point predictive reduced survival, increased NRM, AGVHD. Assessing may be a useful biomarker.