The impact of early CD4+ lymphocyte recovery on the outcome of patients who undergo allogeneic bone marrow or peripheral blood stem cell transplantation
Different factors influence the clinical outcome of allogeneic transplants, the foremost being good immune recovery. The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on ear...
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| Veröffentlicht in: | Blood transfusion = Trasfusione del sangue 2012-04, Vol.10 (2), p.174-180 |
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| creator | Fedele, Roberta Martino, Massimo Garreffa, Cristina Messina, Giuseppe Console, Giuseppe Princi, Domenica Dattola, Antonella Moscato, Tiziana Massara, Elisabetta Spiniello, Elisa Irrera, Giuseppe Iacopino, Pasquale |
| description | Different factors influence the clinical outcome of allogeneic transplants, the foremost being good immune recovery.
The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on early lymphocyte recovery after transplantation. We then analyzed the impact of early CD4+ cell count on overall survival, transplant-related mortality and disease-related mortality.
Univariate analysis with Spearman's rho showed a significant correlation between early CD4+ cell recovery and overall survival, transplant-related mortality, stem cell source and type of donor. In multivariate analysis CD4+ cell count was significantly associated with (i) stem cell source, being higher in patients whose haematopoietic progenitor cells were obtained by apheresis than in those whose source of grafted cells was bone marrow, and (ii) type of donor, being higher in patients transplanted from sibling donors than in those whose graft was from an alternative donor. The ROC curve of CD4+ cell count indicated that a cut-off of 115 CD4+ cells/mL could differentiate groups with different outcomes. At 2 years follow-up, patients achieving this CD4+ cell count had significantly lower cumulative transplant-related mortality compared to patients who did not have this count (10%±4% versus 40%±8%, p=0.0026). At the 5-year follow-up, the overall survival rates were 77.5%±0.6% and 36%±7% (p=0.000) in patients with a CD4+ cell count ≥115/mL and in patients with CD4+ cell count ≤ 115/mL, respectively.
Early CD4+ cell recovery after allogeneic transplantation has a relevant impact on overall survival and transplant-related mortality and is influenced by two factors: stem cell source and type of donor. |
| doi_str_mv | 10.2450/2012.0034-11 |
| format | Article |
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The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on early lymphocyte recovery after transplantation. We then analyzed the impact of early CD4+ cell count on overall survival, transplant-related mortality and disease-related mortality.
Univariate analysis with Spearman's rho showed a significant correlation between early CD4+ cell recovery and overall survival, transplant-related mortality, stem cell source and type of donor. In multivariate analysis CD4+ cell count was significantly associated with (i) stem cell source, being higher in patients whose haematopoietic progenitor cells were obtained by apheresis than in those whose source of grafted cells was bone marrow, and (ii) type of donor, being higher in patients transplanted from sibling donors than in those whose graft was from an alternative donor. The ROC curve of CD4+ cell count indicated that a cut-off of 115 CD4+ cells/mL could differentiate groups with different outcomes. At 2 years follow-up, patients achieving this CD4+ cell count had significantly lower cumulative transplant-related mortality compared to patients who did not have this count (10%±4% versus 40%±8%, p=0.0026). At the 5-year follow-up, the overall survival rates were 77.5%±0.6% and 36%±7% (p=0.000) in patients with a CD4+ cell count ≥115/mL and in patients with CD4+ cell count ≤ 115/mL, respectively.
Early CD4+ cell recovery after allogeneic transplantation has a relevant impact on overall survival and transplant-related mortality and is influenced by two factors: stem cell source and type of donor.</description><identifier>ISSN: 1723-2007</identifier><identifier>DOI: 10.2450/2012.0034-11</identifier><identifier>PMID: 22337266</identifier><language>eng</language><publisher>Italy: Edizioni SIMTI - SIMTI Servizi Srl</publisher><subject>Adolescent ; Adult ; Aged ; Bone Marrow Transplantation - immunology ; Bone Marrow Transplantation - methods ; Bone Marrow Transplantation - mortality ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes - immunology ; Child ; Female ; Graft vs Host Disease - immunology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Original ; Peripheral Blood Stem Cell Transplantation - methods ; Peripheral Blood Stem Cell Transplantation - mortality ; Survival Analysis ; Tissue Donors ; Transplantation Conditioning - methods ; Transplantation, Homologous - immunology ; Transplantation, Homologous - methods ; Transplantation, Homologous - mortality ; Young Adult</subject><ispartof>Blood transfusion = Trasfusione del sangue, 2012-04, Vol.10 (2), p.174-180</ispartof><rights>SIMTI Servizi Srl 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c308t-d9ffff7ed01812714bab0b1e0c614978691f9b14fd8bc10552baf2b36d4f657f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320776/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320776/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22337266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fedele, Roberta</creatorcontrib><creatorcontrib>Martino, Massimo</creatorcontrib><creatorcontrib>Garreffa, Cristina</creatorcontrib><creatorcontrib>Messina, Giuseppe</creatorcontrib><creatorcontrib>Console, Giuseppe</creatorcontrib><creatorcontrib>Princi, Domenica</creatorcontrib><creatorcontrib>Dattola, Antonella</creatorcontrib><creatorcontrib>Moscato, Tiziana</creatorcontrib><creatorcontrib>Massara, Elisabetta</creatorcontrib><creatorcontrib>Spiniello, Elisa</creatorcontrib><creatorcontrib>Irrera, Giuseppe</creatorcontrib><creatorcontrib>Iacopino, Pasquale</creatorcontrib><title>The impact of early CD4+ lymphocyte recovery on the outcome of patients who undergo allogeneic bone marrow or peripheral blood stem cell transplantation</title><title>Blood transfusion = Trasfusione del sangue</title><addtitle>Blood Transfus</addtitle><description>Different factors influence the clinical outcome of allogeneic transplants, the foremost being good immune recovery.
The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on early lymphocyte recovery after transplantation. We then analyzed the impact of early CD4+ cell count on overall survival, transplant-related mortality and disease-related mortality.
Univariate analysis with Spearman's rho showed a significant correlation between early CD4+ cell recovery and overall survival, transplant-related mortality, stem cell source and type of donor. In multivariate analysis CD4+ cell count was significantly associated with (i) stem cell source, being higher in patients whose haematopoietic progenitor cells were obtained by apheresis than in those whose source of grafted cells was bone marrow, and (ii) type of donor, being higher in patients transplanted from sibling donors than in those whose graft was from an alternative donor. The ROC curve of CD4+ cell count indicated that a cut-off of 115 CD4+ cells/mL could differentiate groups with different outcomes. At 2 years follow-up, patients achieving this CD4+ cell count had significantly lower cumulative transplant-related mortality compared to patients who did not have this count (10%±4% versus 40%±8%, p=0.0026). At the 5-year follow-up, the overall survival rates were 77.5%±0.6% and 36%±7% (p=0.000) in patients with a CD4+ cell count ≥115/mL and in patients with CD4+ cell count ≤ 115/mL, respectively.
Early CD4+ cell recovery after allogeneic transplantation has a relevant impact on overall survival and transplant-related mortality and is influenced by two factors: stem cell source and type of donor.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Bone Marrow Transplantation - immunology</subject><subject>Bone Marrow Transplantation - methods</subject><subject>Bone Marrow Transplantation - mortality</subject><subject>CD4 Lymphocyte Count</subject><subject>CD4-Positive T-Lymphocytes - immunology</subject><subject>Child</subject><subject>Female</subject><subject>Graft vs Host Disease - immunology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Original</subject><subject>Peripheral Blood Stem Cell Transplantation - methods</subject><subject>Peripheral Blood Stem Cell Transplantation - mortality</subject><subject>Survival Analysis</subject><subject>Tissue Donors</subject><subject>Transplantation Conditioning - methods</subject><subject>Transplantation, Homologous - immunology</subject><subject>Transplantation, Homologous - methods</subject><subject>Transplantation, Homologous - mortality</subject><subject>Young Adult</subject><issn>1723-2007</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE9P3DAQxX1oxVLg1jOae5XFf7J2cqlUbYFWQuoFzpHtTDapHE_keEH5JnxcgkqrMpc5vHk_vTeMfRZ8K8sdv5JcyC3nqiyE-MBOhZGqkJybDfs0z78510rX1QnbSKmUkVqfsuf7HmEYJ-szUAdoU1hg_738AmEZp578khESenrEtABFyOs9HbOnEV8Nk80DxjzDU09wjC2mA4ENgQ4YcfDgKCKMNiV6AkowYRqmHpMN4AJRC3PGETyGADnZOE_BxrwiKZ6zj50NM1687TP2cHN9v_9R3P26_bn_dld4xatctHW3jsGWi0pII0pnHXcCudeirE2la9HVTpRdWzkv-G4nne2kU7otO70znTpjX_9wp6MbsfVrmTVdM6VhTb00ZIfmvRKHvjnQY6OU5MboFXD5P-Cf8--P1Qum9IC6</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Fedele, Roberta</creator><creator>Martino, Massimo</creator><creator>Garreffa, Cristina</creator><creator>Messina, Giuseppe</creator><creator>Console, Giuseppe</creator><creator>Princi, Domenica</creator><creator>Dattola, Antonella</creator><creator>Moscato, Tiziana</creator><creator>Massara, Elisabetta</creator><creator>Spiniello, Elisa</creator><creator>Irrera, Giuseppe</creator><creator>Iacopino, Pasquale</creator><general>Edizioni SIMTI - SIMTI Servizi Srl</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>5PM</scope></search><sort><creationdate>20120401</creationdate><title>The impact of early CD4+ lymphocyte recovery on the outcome of patients who undergo allogeneic bone marrow or peripheral blood stem cell transplantation</title><author>Fedele, Roberta ; Martino, Massimo ; Garreffa, Cristina ; Messina, Giuseppe ; Console, Giuseppe ; Princi, Domenica ; Dattola, Antonella ; Moscato, Tiziana ; Massara, Elisabetta ; Spiniello, Elisa ; Irrera, Giuseppe ; Iacopino, Pasquale</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c308t-d9ffff7ed01812714bab0b1e0c614978691f9b14fd8bc10552baf2b36d4f657f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Bone Marrow Transplantation - immunology</topic><topic>Bone Marrow Transplantation - methods</topic><topic>Bone Marrow Transplantation - mortality</topic><topic>CD4 Lymphocyte Count</topic><topic>CD4-Positive T-Lymphocytes - immunology</topic><topic>Child</topic><topic>Female</topic><topic>Graft vs Host Disease - immunology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Original</topic><topic>Peripheral Blood Stem Cell Transplantation - methods</topic><topic>Peripheral Blood Stem Cell Transplantation - mortality</topic><topic>Survival Analysis</topic><topic>Tissue Donors</topic><topic>Transplantation Conditioning - methods</topic><topic>Transplantation, Homologous - immunology</topic><topic>Transplantation, Homologous - methods</topic><topic>Transplantation, Homologous - mortality</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fedele, Roberta</creatorcontrib><creatorcontrib>Martino, Massimo</creatorcontrib><creatorcontrib>Garreffa, Cristina</creatorcontrib><creatorcontrib>Messina, Giuseppe</creatorcontrib><creatorcontrib>Console, Giuseppe</creatorcontrib><creatorcontrib>Princi, Domenica</creatorcontrib><creatorcontrib>Dattola, Antonella</creatorcontrib><creatorcontrib>Moscato, Tiziana</creatorcontrib><creatorcontrib>Massara, Elisabetta</creatorcontrib><creatorcontrib>Spiniello, Elisa</creatorcontrib><creatorcontrib>Irrera, Giuseppe</creatorcontrib><creatorcontrib>Iacopino, Pasquale</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Blood transfusion = Trasfusione del sangue</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fedele, Roberta</au><au>Martino, Massimo</au><au>Garreffa, Cristina</au><au>Messina, Giuseppe</au><au>Console, Giuseppe</au><au>Princi, Domenica</au><au>Dattola, Antonella</au><au>Moscato, Tiziana</au><au>Massara, Elisabetta</au><au>Spiniello, Elisa</au><au>Irrera, Giuseppe</au><au>Iacopino, Pasquale</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of early CD4+ lymphocyte recovery on the outcome of patients who undergo allogeneic bone marrow or peripheral blood stem cell transplantation</atitle><jtitle>Blood transfusion = Trasfusione del sangue</jtitle><addtitle>Blood Transfus</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>10</volume><issue>2</issue><spage>174</spage><epage>180</epage><pages>174-180</pages><issn>1723-2007</issn><abstract>Different factors influence the clinical outcome of allogeneic transplants, the foremost being good immune recovery.
The purpose of this study was to evaluate the influence of different factors, such as stem cell source, type of donor, conditioning regimen and acute graft-versus-host disease, on early lymphocyte recovery after transplantation. We then analyzed the impact of early CD4+ cell count on overall survival, transplant-related mortality and disease-related mortality.
Univariate analysis with Spearman's rho showed a significant correlation between early CD4+ cell recovery and overall survival, transplant-related mortality, stem cell source and type of donor. In multivariate analysis CD4+ cell count was significantly associated with (i) stem cell source, being higher in patients whose haematopoietic progenitor cells were obtained by apheresis than in those whose source of grafted cells was bone marrow, and (ii) type of donor, being higher in patients transplanted from sibling donors than in those whose graft was from an alternative donor. The ROC curve of CD4+ cell count indicated that a cut-off of 115 CD4+ cells/mL could differentiate groups with different outcomes. At 2 years follow-up, patients achieving this CD4+ cell count had significantly lower cumulative transplant-related mortality compared to patients who did not have this count (10%±4% versus 40%±8%, p=0.0026). At the 5-year follow-up, the overall survival rates were 77.5%±0.6% and 36%±7% (p=0.000) in patients with a CD4+ cell count ≥115/mL and in patients with CD4+ cell count ≤ 115/mL, respectively.
Early CD4+ cell recovery after allogeneic transplantation has a relevant impact on overall survival and transplant-related mortality and is influenced by two factors: stem cell source and type of donor.</abstract><cop>Italy</cop><pub>Edizioni SIMTI - SIMTI Servizi Srl</pub><pmid>22337266</pmid><doi>10.2450/2012.0034-11</doi><tpages>7</tpages></addata></record> |
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| ispartof | Blood transfusion = Trasfusione del sangue, 2012-04, Vol.10 (2), p.174-180 |
| issn | 1723-2007 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3320776 |
| source | MEDLINE; PubMed Central; EZB Electronic Journals Library |
| subjects | Adolescent Adult Aged Bone Marrow Transplantation - immunology Bone Marrow Transplantation - methods Bone Marrow Transplantation - mortality CD4 Lymphocyte Count CD4-Positive T-Lymphocytes - immunology Child Female Graft vs Host Disease - immunology Humans Male Middle Aged Multivariate Analysis Original Peripheral Blood Stem Cell Transplantation - methods Peripheral Blood Stem Cell Transplantation - mortality Survival Analysis Tissue Donors Transplantation Conditioning - methods Transplantation, Homologous - immunology Transplantation, Homologous - methods Transplantation, Homologous - mortality Young Adult |
| title | The impact of early CD4+ lymphocyte recovery on the outcome of patients who undergo allogeneic bone marrow or peripheral blood stem cell transplantation |
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