TY - JOUR
T1 - Prognostic analysis of pre-transplant peripheral T-cell levels in patients receiving an autologous hematopoietic progenitor-cell transplant
AU - Rosinski, Steven L.
AU - McNiece, I. K.
AU - Shpall, E. J.
AU - Clough, N.
AU - Russell, P.
AU - Blunk, B.
AU - Nieto, Y.
PY - 2005/9
Y1 - 2005/9
N2 - The purpose of this study was to evaluate pre-transplant T-cell status in autologous hematopoietic progenitor-cell transplantation (HPCT) recipients. Between 1999 and 2002 we prospectively enrolled 85 autologous HPCT recipients with solid tumors (N = 50) or hematological malignancies (n = 35). Patient diagnoses included breast cancer (N = 49), non-Hodgkin's lymphoma (N = 20), myeloma (N = 11), Hodgkin's disease (N = 3), germ-cell tumor (N = 1) and amyloidosis (N = 1). Levels of CD3, CD4, CD8, memory and naïve CD4, and CD8 T-cell subsets were analyzed before autologous HPCT. Autologous HPCT recipients presented with lower pre-transplant counts of CD3, CD4, but not CD8 T cells, as compared to healthy controls. Pre-transplant CD4 T-cell levels correlated with progression-free survival (PFS) (P = 0.002) and overall survival (OS) (P = 0.05), in patients with hematologic malignancies (P = 0.02) and breast cancer (P = 0.04). Specifically, pre-transplant memory CD4+CD45RA-CD62L- T-cell levels correlated with PFS (P = 0.01). The prognostic effects of pre-transplant CD4 and CD4+CD45RA-CD62L- T cells were independent of tumor diagnosis, tumor stage, tumor sensitivity, and, for breast cancer patients, Her2/neu status. Our results suggest that pre-transplant CD4 T-cell status, specifically CD4+CD45RA-CD62L- memory T cells, correlates with the outcome of autologous HPCT recipients. These observations suggest the feasibility of prospective identification of those patients at higher risk of relapse, based on their immune status.
AB - The purpose of this study was to evaluate pre-transplant T-cell status in autologous hematopoietic progenitor-cell transplantation (HPCT) recipients. Between 1999 and 2002 we prospectively enrolled 85 autologous HPCT recipients with solid tumors (N = 50) or hematological malignancies (n = 35). Patient diagnoses included breast cancer (N = 49), non-Hodgkin's lymphoma (N = 20), myeloma (N = 11), Hodgkin's disease (N = 3), germ-cell tumor (N = 1) and amyloidosis (N = 1). Levels of CD3, CD4, CD8, memory and naïve CD4, and CD8 T-cell subsets were analyzed before autologous HPCT. Autologous HPCT recipients presented with lower pre-transplant counts of CD3, CD4, but not CD8 T cells, as compared to healthy controls. Pre-transplant CD4 T-cell levels correlated with progression-free survival (PFS) (P = 0.002) and overall survival (OS) (P = 0.05), in patients with hematologic malignancies (P = 0.02) and breast cancer (P = 0.04). Specifically, pre-transplant memory CD4+CD45RA-CD62L- T-cell levels correlated with PFS (P = 0.01). The prognostic effects of pre-transplant CD4 and CD4+CD45RA-CD62L- T cells were independent of tumor diagnosis, tumor stage, tumor sensitivity, and, for breast cancer patients, Her2/neu status. Our results suggest that pre-transplant CD4 T-cell status, specifically CD4+CD45RA-CD62L- memory T cells, correlates with the outcome of autologous HPCT recipients. These observations suggest the feasibility of prospective identification of those patients at higher risk of relapse, based on their immune status.
KW - Autologous transplantation
KW - Immune recovery
KW - Prognostic factor
KW - T-cell recovery
UR - http://www.scopus.com/inward/record.url?scp=30944464620&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=30944464620&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1705073
DO - 10.1038/sj.bmt.1705073
M3 - Article
C2 - 15980880
AN - SCOPUS:30944464620
SN - 0268-3369
VL - 36
SP - 425
EP - 430
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 5
ER -