Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Transplant Proc. 2021 Jan-Feb;53(1):379-385. doi: 10.1016/j.transproceed.2020.03.027. Epub 2020 May 7.
Our previous study demonstrated that the soluble interleukin-2 receptor (sIL-2R) index, defined as the ratio of serum sIL-2R levels at neutrophil engraftment to that before conditioning, is a biomarker that can predict acute graft-vs-host disease (GVHD) after unrelated bone marrow transplantation. In the present study, we evaluated the significance of the sIL-2R index among patients who underwent cord blood transplantation (CBT).
We retrospectively analyzed 31 patients who underwent single-unit CBT as their first transplantation for hematologic malignancies.
The median sIL-2R index was 4.2. The cumulative incidence of grade II to IV acute GVHD was not associated with the sIL-2R index. However, the cumulative incidence of relapse at 3 years after transplantation was significantly lower, with an sIL-2R index ≥ 3.7 than with an index < 3.7 (12.8% vs 50.0%; P = .04). As a result, the probability of overall survival at 3 years after transplantation was significantly higher in the former group than in the latter (79.8% vs 20.0%; P < .01). Only the dose of corticosteroid administered in the pre-engraftment period influenced the sIL-2 index.
The sIL-2R index can predict the incidence of relapse and probability of survival after CBT, possibly reflecting a graft-vs-leukemia effect.
我们之前的研究表明，可溶性白细胞介素 2 受体（sIL-2R）指数，定义为中性粒细胞植入时血清 sIL-2R 水平与预处理前水平的比值，是一种可以预测异基因骨髓移植后急性移植物抗宿主病（GVHD）的生物标志物。在本研究中，我们评估了 sIL-2R 指数在接受脐带血移植（CBT）患者中的意义。
我们回顾性分析了 31 例接受单份脐带血移植作为血液系统恶性肿瘤首次移植的患者。
中位数 sIL-2R 指数为 4.2。Ⅱ至Ⅳ级急性 GVHD 的累积发生率与 sIL-2R 指数无关。然而，移植后 3 年的复发累积发生率明显较低，sIL-2R 指数≥3.7 的患者为 12.8%，而 sIL-2R 指数<3.7 的患者为 50.0%（P=.04）。因此，前者组移植后 3 年的总生存率明显高于后者（79.8% vs 20.0%；P<.01）。只有移植前期间皮质类固醇的剂量影响 sIL-2 指数。
sIL-2R 指数可预测 CBT 后复发的发生率和生存率，可能反映了移植物抗白血病效应。
