BACKGROUND: Different factors influence the clinical outcome of allogeneic transplants, the foremost being good immune recovery. MATERIALS AND METHODS: The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on early lymphocyte recovery after transplantation. We then analyzed the impact of early CD4+ cell count on overall survival, transplant-related mortality and disease-related mortality. RESULTS: Univariate analysis with Spearman's rho showed a significant correlation between early CD4+ cell recovery and overall survival, transplant-related mortality, stem cell source and type of donor. In multivariate analysis CD4+ cell count was significantly associated with (i) stem cell source, being higher in patients whose haematopoietic progenitor cells were obtained by apheresis than in those whose source of grafted cells was bone marrow, and (ii) type of donor, being higher in patients transplanted from sibling donors than in those whose graft was from an alternative donor. The ROC curve of CD4+ cell count indicated that a cut-off of 115 CD4+ cells/mL could differentiate groups with different outcomes. At 2 years follow-up, patients achieving this CD4+ cell count had significantly lower cumulative transplant-related mortality compared to patients who did not have this count (10%±4% versus 40%±8%, p=0.0026). At the 5-year follow-up, the overall survival rates were 77.5%±0.6% and 36%±7% (p=0.000) in patients with a CD4+ cell count ≥115/mL and in patients with CD4+ cell count ≤ 115/mL, respectively. CONCLUSION: Early CD4+ cell recovery after allogeneic transplantation has a relevant impact on overall survival and transplant-related mortality and is influenced by two factors: stem cell source and type of donor.
BACKGROUND: Different factors influence the clinical outcome of allogeneic transplants, the foremost being good immune recovery. MATERIALS AND METHODS: The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on early lymphocyte recovery after transplantation. We then analyzed the impact of early CD4+ cell count on overall survival, transplant-related mortality and disease-related mortality. RESULTS: Univariate analysis with Spearman's rho showed a significant correlation between early CD4+ cell recovery and overall survival, transplant-related mortality, stem cell source and type of donor. In multivariate analysis CD4+ cell count was significantly associated with (i) stem cell source, being higher in patients whose haematopoietic progenitor cells were obtained by apheresis than in those whose source of grafted cells was bone marrow, and (ii) type of donor, being higher in patients transplanted from sibling donors than in those whose graft was from an alternative donor. The ROC curve of CD4+ cell count indicated that a cut-off of 115 CD4+ cells/mL could differentiate groups with different outcomes. At 2 years follow-up, patients achieving this CD4+ cell count had significantly lower cumulative transplant-related mortality compared to patients who did not have this count (10%±4% versus 40%±8%, p=0.0026). At the 5-year follow-up, the overall survival rates were 77.5%±0.6% and 36%±7% (p=0.000) in patients with a CD4+ cell count ≥115/mL and in patients with CD4+ cell count ≤ 115/mL, respectively. CONCLUSION: Early CD4+ cell recovery after allogeneic transplantation has a relevant impact on overall survival and transplant-related mortality and is influenced by two factors: stem cell source and type of donor.
Authors: W J Savage; J J Bleesing; D Douek; M R Brown; G M Linton; H L Malech; M E Horwitz Journal: Bone Marrow Transplant Date: 2001-09 Impact factor: 5.483
Authors: Robert Lowsky; Tsuyoshi Takahashi; Yin Ping Liu; Sussan Dejbakhsh-Jones; F Carl Grumet; Judith A Shizuru; Ginna G Laport; Keith E Stockerl-Goldstein; Laura J Johnston; Richard T Hoppe; Daniel A Bloch; Karl G Blume; Robert S Negrin; Samuel Strober Journal: N Engl J Med Date: 2005-09-29 Impact factor: 91.245
Authors: S Morecki; Y Gelfand; A Nagler; R Or; E Naparstek; G Varadi; D Engelhard; A Akerstein; S Slavin Journal: Bone Marrow Transplant Date: 2001-08 Impact factor: 5.483
Authors: Morgan Hakki; Stanley R Riddell; Jan Storek; Rachel A Carter; Terry Stevens-Ayers; Patrick Sudour; Kristen White; Lawrence Corey; Michael Boeckh Journal: Blood Date: 2003-07-03 Impact factor: 22.113
Authors: Nina Worel; Peter Kalhs; Felix Keil; Erika Prinz; Karin Moser; Axel Schulenburg; Margit Mitterbauer; Christine Mannhalter; Wolfgang R Mayr; Ilse Schwarzinger; Paul Höcker; Klaus Lechner; Hildegard T Greinix Journal: Transfusion Date: 2003-08 Impact factor: 3.157
Authors: M Eyrich; C Leiler; P Lang; K Schilbach; M Schumm; P Bader; J Greil; T Klingebiel; R Handgretinger; D Niethammer; P G Schlegel Journal: Bone Marrow Transplant Date: 2003-08 Impact factor: 5.483
Authors: Ichelle van Roessel; Susan Prockop; Elizabeth Klein; Farid Boulad; Andromachi Scaradavou; Barbara Spitzer; Andrew Kung; Kevin Curran; Richard J O'Reilly; Nancy A Kernan; Maria Cancio; Jaap Jan Boelens Journal: Cytotherapy Date: 2020-07-01 Impact factor: 5.414
Authors: T W H Flinsenberg; L Spel; M Jansen; D Koning; C de Haar; M Plantinga; R Scholman; M M van Loenen; S Nierkens; L Boon; D van Baarle; M H M Heemskerk; J J Boelens; M Boes Journal: J Virol Date: 2014-11-05 Impact factor: 5.103
Authors: Haesook T Kim; David Frederick; Philippe Armand; Emily Andler; Grace Kao; Corey Cutler; John Koreth; Edwin P Alyea; Joseph H Antin; Robert J Soiffer; Jerome Ritz; Vincent T Ho Journal: Am J Hematol Date: 2014-03-03 Impact factor: 10.047
Authors: Henning Schäfer; Jacqueline Blümel-Lehmann; Gabriele Ihorst; Hartmut Bertz; Ralph Wäsch; Robert Zeiser; Jürgen Finke; Reinhard Marks Journal: Ann Hematol Date: 2021-03-23 Impact factor: 3.673
Authors: Oriana Miltiadous; Nicholas R Waters; Hana Andrlová; Anqi Dai; Chi L Nguyen; Marina Burgos da Silva; Sarah Lindner; John Slingerland; Paul Giardina; Annelie Clurman; Gabriel K Armijo; Antonio L C Gomes; Madhavi Lakkaraja; Peter Maslak; Michael Scordo; Roni Shouval; Anna Staffas; Richard O'Reilly; Ying Taur; Susan Prockop; Jaap Jan Boelens; Sergio Giralt; Miguel-Angel Perales; Sean M Devlin; Jonathan U Peled; Kate A Markey; Marcel R M van den Brink Journal: Blood Date: 2022-05-05 Impact factor: 25.476