The immune reconstitution after an allogeneic stem cell transplant correlates with the risk of graft-versus-host disease and cytomegalovirus infection

Torelli, Giovanni Fernando; Lucarelli, Barbarella; Iori, Anna Paola; Propris, M. S. De; Capobianchi, Angela; Barberi, Walter; Valle, Veronica; Iannella, Emilia; Natalino, Fiammetta; Mercanti, Caterina; Perrone, Salvatore; Gentile, Giuseppe; Guarini, Anna; Foà, Robin

doi:10.1016/j.leukres.2011.03.009

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…[69][70][71][72] Initial studies regarding adoptive cell therapy with donor-derived regulatory T cells have also shown improved T-cell reconstitution and less GVHD. 73 …”

Section: Growth Hormone (Gh)mentioning

confidence: 99%

Immune reconstitution following stem cell transplantation

2015

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“…[69][70][71][72] Initial studies regarding adoptive cell therapy with donor-derived regulatory T cells have also shown improved T-cell reconstitution and less GVHD. 73 …”

Section: Growth Hormone (Gh)mentioning

confidence: 99%

Immune reconstitution following stem cell transplantation

2015

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“…The graft consists of CD34 + stem cells obtained from related or unrelated donors mixed with a smaller or larger number of mature immune cells. Stem cells obtained from peripheral blood contain larger number of haematopoietic cells and give faster engraftment, but are also associated with an increased incidence of graft‐ versus ‐host disease (GVHD) [2]. The goal for the procedure is a haematopoietic system that produces fully functional erythrocytes, thrombocytes, myeloid cell lineages and lymphocytes.…”

Section: Haematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Translational Mini-Review Series on B cell subsets in disease. Reconstitution after haematopoietic stem cell transplantation – revelation of B cell developmental pathways and lineage phenotypes

Bemark

Holmqvist

Abrahamsson

et al. 2011

Clinical and Experimental Immunology

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SummaryHaematopoietic stem cell transplantation (HSCT) is an immunological treatment that has been used for more than 40 years to cure a variety of diseases. The procedure is associated with serious side effects, due to the severe impairment of the immune system induced by the treatment. After a conditioning regimen with high-dose chemotherapy, sometimes in combination with total body irradiation, haematopoietic stem cells are transferred from a donor, allowing a donor-derived blood system to form. Here, we discuss the current knowledge of humoral problems and B cell development after HSCT, and relate these to the current understanding of human peripheral B cell development. We describe how these studies have aided the identification of subsets of transitional B cells and also a robust memory B cell phenotype.

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“…Successful tumor elimination relies partially on a graftversus-leukemia (GVL) response that is mediated by the donor immune response and established within the first few weeks following transplantation. [1][2][3] Although many studies have related the clinical outcome of transplantation to features of immune reconstitution [4][5][6][7] or donor/host genotype, 8,9 the potential importance of the cellular composition within the initial stem cell infusion remains poorly defined. Indeed, the number and diversity of immune cells within this product would be expected to influence immune reconstitution and could play a significant role in determining patient outcome.…”

Section: Introductionmentioning

confidence: 99%

The number of CD56dim NK cells in the graft has a major impact on risk of disease relapse following allo-HSCT

et al. 2017

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Key Points• A stem cell graft NK cell dose below 6.3 3 10 6 cells per kg associates with risk of disease relapse following T-cell-depleted allo-HSCT.• Clinical outcomes of patients undergoing allo-HSCT may be improved by setting an NK cell threshold within donor stem cell grafts.The graft-versus-leukemia (GVL) effect of allogeneic hemopoietic stem cell transplantation (allo-HSCT) is mediated by the donor immune system and acts to decrease the rate of disease relapse. Although studies of posttransplant immune reconstitution have identified correlates of clinical outcome, the number and profile of mature immune cells infused with the stem cell graft is also likely to be an important determinant and has been relatively poorly studied.We characterized immune cells within the stem cell graft of 107 patients who underwent T-cell-depleted allo-HSCT and related this to clinical outcome. The number of natural killer (NK) cells and T cells that were infused varied markedly between patients, but T-cell dosewas not an important factor in subsequent outcome. In contrast, the number of NK cells was a powerful determinant of the risk of disease relapse. Patients who received an NK cell dose below the median level of 6.3 3 10 6 cells per kg had a relapse rate of 40% at 2 years posttransplant compared with only 6% for those whose stem cell graft contained a dose above this value. Analysis of NK subsets showed that this effect was mediated primarily by the CD56 dim population of mature effector cells and that high-level expression of the activatory protein DNAM on donor NK cells was also strongly protective. These observations offer important insights into the mechanism of GVL and suggest that optimization studies of the number of NK cells within the stem cell graft should be considered as a means to reduce disease relapse.

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The immune reconstitution after an allogeneic stem cell transplant correlates with the risk of graft-versus-host disease and cytomegalovirus infection

Cited by 9 publications

References 5 publications

Immune reconstitution following stem cell transplantation

Immune reconstitution following stem cell transplantation

Translational Mini-Review Series on B cell subsets in disease. Reconstitution after haematopoietic stem cell transplantation – revelation of B cell developmental pathways and lineage phenotypes

The number of CD56dim NK cells in the graft has a major impact on risk of disease relapse following allo-HSCT

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