自体自然杀伤细胞/CD14+HLA-DR 细胞比例输注可预测自体造血干细胞移植后淋巴瘤的生存。
Infusion of autograft natural killer cell/CD14HLA-DR cell ratio predicts survival in lymphoma post autologous stem cell transplantation.
机构信息
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
出版信息
Bone Marrow Transplant. 2018 Feb;53(2):146-154. doi: 10.1038/bmt.2017.225. Epub 2017 Oct 16.
The infusion of autograft absolute lymphocyte count (A-ALC) and autograft natural killer cells (A-NKC) are prognostic factors for overall survival (OS) and PFS in non-Hodgkin's lymphoma (NHL) patients undergoing autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT). The human monocytic CD14HLA-DR cells are associated with worse prognosis in NHL. Thus, we investigated whether the autograft A-NKC/A-CD14HLA-DR ratio predicts survival in NHL. In a total of 111 NHL patients, we analyzed apheresis collection samples for the content of A-NKC and A-CD14HLA-DR. With a median follow-up of 57.2 months (range: 2.1-84.6 months), patients with an A-NKC/A-CD14HLA-DR ratio of ⩾0.29 experienced superior OS (5-year OS rates of 84% (95% confidence interval (CI), 72-91%) vs 48% (95% CI, 34-62%), P<0.0002, respectively) and PFS (5-year PFS rates of 59% (95% CI, 47-71%) vs 32% (95% CI, 20-48%), P<0.002, respectively). Multivariate analysis revealed that A-NKC/A-CD14HLA-DR ratio was an independent predictor for PFS (hazard ratio (HR)=0.56, 95% CI, 0.32-0.96, P<0.03) and OS (HR=0.34, 95% CI, 0.16-0.68, P<0.002). The A-NKC/A-CD14HLA-DR ratio provides a platform to target specific autograft immune effector cells to improve clinical outcomes in NHL patients undergoing APBHSCT.
输注自体绝对淋巴细胞计数（A-ALC）和自体自然杀伤细胞（A-NKC）是接受自体外周血造血干细胞移植（APBHSCT）的非霍奇金淋巴瘤（NHL）患者总生存（OS）和无进展生存（PFS）的预后因素。人类单核细胞 CD14HLA-DR 细胞与 NHL 的预后较差相关。因此，我们研究了自体 A-NKC/A-CD14HLA-DR 比值是否可预测 NHL 患者的生存情况。在总共 111 例 NHL 患者中，我们分析了采集样本中 A-NKC 和 A-CD14HLA-DR 的含量。中位随访时间为 57.2 个月（范围：2.1-84.6 个月），A-NKC/A-CD14HLA-DR 比值 ⩾0.29 的患者具有更好的 OS（5 年 OS 率分别为 84%（95%置信区间（CI），72-91%）和 48%（95%CI，34-62%），P<0.0002）和 PFS（5 年 PFS 率分别为 59%（95%CI，47-71%）和 32%（95%CI，20-48%），P<0.002）。多变量分析显示，A-NKC/A-CD14HLA-DR 比值是 PFS（风险比（HR）=0.56，95%CI，0.32-0.96，P<0.03）和 OS（HR=0.34，95%CI，0.16-0.68，P<0.002）的独立预测因素。A-NKC/A-CD14HLA-DR 比值为针对特定自体免疫效应细胞提供了一个平台，可改善接受 APBHSCT 的 NHL 患者的临床结局。
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