Early CD8+-recovery independently predicts low probability of disease relapse but also associates with severe GVHD after allogeneic HSCT

PLoS One. 2018 Sep 20;13(9):e0204136. doi: 10.1371/journal.pone.0204136. eCollection 2018.

Abstract

In this single-center study we retrospectively evaluated the impact of early reconstitution of different lymphocyte subsets on patient outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We found that CD8+ T-cell counts exceeding 50x10(6)/l as early as on day 28 post-transplantation correlated significantly with decreased relapse risk, with three-year relapse rates of 17.0% and 55.6% (P = 0.002), but were also associated with severe acute and chronic GVHD. Incidence of grade III-IV acute GVHD was 30.5% for those with early CD8+ T-cell recovery compared to 2.1% for those with lower CD8+ T-cell counts on day 28 post-transplant (HR = 20.24, P = 0.004). Early CD8+ T-cell reconstitution did not, however, affect the overall survival. Multivariate analysis showed that slow CD8+ T-cell reconstitution was strongly associated with increased risk of relapse (HR = 3.44, P = 0.026). A weaker correlation was found between CD4+ reconstitution and relapse-risk, but there was no such association with CD19+ B-cells or NK-cells. In conclusion, the early CD8+ T-cell recovery on day 28 post-transplant is associated with the lower risk of relapse but also predicts the impending severe GVHD, and thus could be useful in guiding timely treatment decisions.

MeSH terms

  • CD8-Positive T-Lymphocytes / immunology*
  • Chronic Disease
  • Disease-Free Survival
  • Female
  • Graft vs Host Disease / etiology*
  • Graft vs Host Disease / immunology*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Kinetics
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Probability*
  • Proportional Hazards Models
  • Recurrence
  • Risk Factors
  • Transplantation, Homologous / adverse effects

Grants and funding

The authors received no spesific funding for this work.