Circulating CD3⁺CD4⁺CD161⁺Cells Are Associated with Early Complications after Autologous Stem Cell Transplantation in Multiple Myeloma

Abstract

The aim of this study was to explore if measurement of pretransplant circulating CD161-expressing cells, in addition to clinical risk factors, could predict mucositis and infections in patients with multiple myeloma (MM) undergoing autologous stem cell transplantation (ASCT). To determine if CD161-expressing cells are likely to predict early complications, namely, mucositis (≥grade 3), infections, and cytomegalovirus (CMV) reactivation, we prospectively examined CD161-expressing cells (CD3+CD4+CD161+ and CD3+CD8+CD161+) in peripheral blood samples from 108 patients with MM undergoing ASCT. After adjusting for factors identified by univariate analysis that predicted mucositis (≥grade 3), infection before engraftment, and CMV reactivation, multivariate analyses revealed that the low proportion of CD3+CD4+CD161+ cells in peripheral blood was an independent predictor of mucositis (≥grade 3) (P = 0.020), infections before engraftment (P = 0.014), and CMV reactivation (P = 0.010). In addition, we found that female sex and decreased glomerular filtration rate were independent factors for predicting mucositis. Female sex and severe pulmonary comorbidity were independent factors for predicting infection before engraftment. We found that the proportion of circulating CD3+CD4+CD161+ cells is useful for predicting the occurrence of early complications, including mucositis and infections, after ASCT in patients with MM.

Low frequency of CD3+CD4+CD161+ T cells correlates with the occurrence of infections in refractory/relapsed multiple myeloma patients receiving lenalidomide plus low-dose dexamethasone treatment

“…Recently, we reported that the proportion of pretransplant circulating CD3 + CD4 + CD161 + cells in the allogeneic stem cell transplant setting was associated with the occurrence of neutropenic inf e c t i o n s , w h i c h s u g g e s t e d t h e i m p o r t a n c e o f CD3 + CD4 + CD161 + cells in the rapid immune response to microorganisms before establishment of the post-transplant immune system [31]. The relation between pretransplant CD3 + CD4 + CD161 + cells and the occurrence of early complications was also seen in autologous stem cell transplant setting [32]. In this study, we found that the presence of preexisting CD3 + CD4 + CD161 + cells may play an important role in decreasing the risk of severe infection in patients with RRMM during Len-dex therapy.…”

Drug targets and resistance mechanisms in multiple myeloma

“…The presence of CPCs at the time of autologous PBSC collection is a negative prognostic factor for risk of early relapse or death despite the advent of novel agents and maintenance strategies [221] . Circulating CD161-expressing cells, in addition to clinical risk factors, predict mucositis and infections in MM patients undergoing ASCT [222] . In 2017, the U.S. Food and Drug Administration (FDA) approved lenalidomide as maintenance therapy after ASCT for MM patients.…”

Immune reconstitution following umbilical cord blood transplantation: IRES, a study of UK paediatric patients

“…Neutrophil and platelet recovery remain the primary indicators of engraftment, but there is increasing evidence that the appearance of lymphoid and myeloid populations and sub‐populations can correlate with successful transplant outcomes [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Although early indicators of engraftment tend to be delayed with cord blood, some lymphoid populations may appear more quickly and/or to higher levels than with adult sources and therefore compensate to some extent for other deficits [ 4 , 10 , 20 ].…”