Strong increase in the percentage of the CD8bright+ CD28- T-cells and delayed engraftment associated with cyclosporine-induced autologous GVHD

Eur J Haematol. 1996 Mar;56(3):119-23. doi: 10.1111/j.1600-0609.1996.tb01329.x.

Abstract

Four children with acute lymphoblastic leukaemia had autologous bone marrow (BM) or peripheral stem cell (PSC) transplantation with low dose of cyclosporine (CsA, img/kg/d i.v. during the first 28 d) to induce an autologous GVHD (auto-GVHD). Two children did not have clinical auto-GVHD and they relapsed 3 and 4 months after treatment. The 2 other children had clinical signs of auto-GVHD (grade I and grade II); they both are in complete remission but after a first normal haematological recovery they had a prolonged period of aplasia until month 9 for 1 patient and still persistent at month 7 in the other case. We studied lymphocyte subsets reconstitution after transplantation in these patients. All patients had an important decrease in the CD4/CD8 ratio related both to a strong decrease in the CD4+ cells and a strong increase in the CD8+ cells. Most of the CD8+ cells were of the CD8bright+ CD28- phenotype. These CD8bright+ CD28- T-cells represented from 33% to 68% of the total lymphocytes. We discuss the role of these cells after autologous transplantation with CsA, and wonder if these cells could mediate cytotoxicity. In conclusion, among 4 children who received autologous BM or PBC transplantation with low dose of CsA, we observed a complete remission after an auto-GVHD and a prolonged period of aplasia in 2 patients and a relapse of leukaemia in 2 other patients. All these 4 patients had an increase in the CD8bright+ CD28- T lymphocytes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases / chemically induced*
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / pathology
  • Bone Marrow Transplantation / immunology*
  • CD28 Antigens / analysis*
  • Child
  • Child, Preschool
  • Cyclosporine / therapeutic use*
  • Female
  • Follow-Up Studies
  • Graft Rejection / immunology*
  • Graft Rejection / pathology
  • Graft vs Host Disease / chemically induced*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / pathology
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Leukocyte Count
  • Male
  • Neoplasm Recurrence, Local / prevention & control
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Remission Induction
  • T-Lymphocyte Subsets / immunology*
  • T-Lymphocytes, Cytotoxic / immunology*
  • Transplantation, Autologous / immunology*
  • Treatment Outcome

Substances

  • CD28 Antigens
  • Cyclosporine