Department of Haematology, Christian Medical College, Vellore, India.
Biol Blood Marrow Transplant. 2010 Jun;16(6):854-60. doi: 10.1016/j.bbmt.2010.01.013. Epub 2010 Feb 4.
We investigated the impact of the number of infused and reconstituted immunocompetent cells including dendritic cells (DCs) on clinical outcome of patients with hematologic malignancies undergoing an allogeneic peripheral blood stem cell transplantation. Sixty-nine consecutive patients with hematologic malignancies were included in the analysis. The median age of the cohort was 32 years (range: 2-62 years) and there were 39 (57%) males. Twenty-one (30%) patients relapsed with a cumulative incidence of 44 % +/- 14% at a median follow up of 28 months. On a multivariate analysis, a high plasmacytoid dendritic cell (PC) content in the graft was associated with higher risk of relapse. The patients were further categorized based on the median PC counts in the graft as high (> or =2.3 x 10(6)/kg) and low (<2.3 x 10(6)/kg) groups. The baseline characteristics of these 2 groups were comparable. The group that had a high PC content in the graft had significantly higher risk of relapse and lower overall survival (OS) and event-free survival (EFS). Our data suggests that PC content in the graft predicts clinical outcomes such as relapse and survival in patients with hematologic malignancies undergoing an allogeneic HLA matched related peripheral blood stem cell transplantation. There is potential for pretransplant manipulation of this cellular subset in the graft.
我们研究了输注和再构成的免疫活性细胞(包括树突状细胞[DC])数量对接受异基因外周血造血干细胞移植的血液恶性肿瘤患者临床结局的影响。分析纳入了 69 例连续的血液恶性肿瘤患者。队列的中位年龄为 32 岁(范围:2-62 岁),男性 39 例(57%)。21 例(30%)患者复发,累积发生率为 44%±14%,中位随访时间为 28 个月。多变量分析显示,移植物中高水平的浆细胞样树突状细胞(PC)与更高的复发风险相关。根据移植物中 PC 计数的中位数,患者进一步分为高(>或=2.3×10(6)/kg)和低(<2.3×10(6)/kg)组。这两组的基线特征相似。移植物中 PC 含量高的组复发风险显著增加,总生存率(OS)和无事件生存率(EFS)降低。我们的数据表明,移植物中 PC 含量可预测血液恶性肿瘤患者接受 HLA 匹配相关异基因外周血造血干细胞移植后的复发和生存等临床结局。在移植前对该细胞亚群进行预处理可能具有潜力。