Thymic function after allogeneic stem cell transplantation is dependent on graft source and predictive of long term survival

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• 作者：Darius Sairafi^a ; ^b ; ^{darius.sairafi@ki.se} ; Jonas Mattsson^a ; ^b ; ^{jonas.mattsson@ki.se} ; Michael Uhlin^b ; ^{michael.uhlin@ki.se} ; Mehmet Uzunel^b ; ^{mehmet.uzunel@ki.se}
• 关键词：ASCT ; allogeneic stem cell transplantation ; TREC ; T-cell receptor excision circle ; TRM ; transplant-related mortality ; MAC ; myeloablative conditioning regimen ; RIC ; reduced intensity conditioning regimen ; ATG ; anti-thymocyte globulin ; MUD ; matched unrelate
• 刊名：Clinical Immunology
• 出版年：2012
• 期刊代码：95_15216616
• 类别：imm
• 出版时间：March, 2012
• 卷：142
• 期：3
• 页码：343-350
• 文件大小：582 K

摘要

T-cell deficiency after allogeneic stem cell transplantation (ASCT) is common and has major impact on clinical outcome. In this retrospective study 210 patients were analyzed with regards to levels of T-cell receptor excision circles (TRECs) during the first 24 months after transplantation. We could for the first time show a significant correlation between the use of bone marrow grafts and higher TREC levels > 6 months post-ASCT (p < 0.001). Treatment with anti-thymocyte globulin was correlated with lower TREC levels 鈮?#xA0;6 months post-ASCT (p < 0.001). Patients with TREC levels above median at 3 months had a superior overall survival, 80%vs. 56%(p = 0.002), and lower transplantation-related mortality, 7%vs. 21%(p = 0.01). We conclude that graft source and conditioning regimen may have a significant effect on T-cell reconstitution after ASCT and can thus affect outcome. These results strongly support the use of TREC measurement as part of the standard repertoire of immunological monitoring after ASCT.