Clinical outcomes and early immune reconstitution in patients with acute lymphoblastic leukemia underwent allogeneic hematopoietic stem cell transplantation

Huiyu LI; Tong CUI; Shijia LI; Shiyuan ZHOU; Wenjuan ZHU; Jing LI; Xiao MA; Xiaojin WU

doi:10.13303/j.cjbt.issn.1004-549x.2023.09.005

Zhongguo shuxue zazhi (Sep 2023)

Clinical outcomes and early immune reconstitution in patients with acute lymphoblastic leukemia underwent allogeneic hematopoietic stem cell transplantation

Huiyu LI,
Tong CUI,
Shijia LI,
Shiyuan ZHOU,
Wenjuan ZHU,
Jing LI,
Xiao MA,
Xiaojin WU

Affiliations

Huiyu LI: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Tong CUI: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Shijia LI: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Shiyuan ZHOU: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Wenjuan ZHU: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Jing LI: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Xiao MA: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China
Xiaojin WU: National Clinical Research Center for Hematologic Disease, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, Suzhou 215006, China

DOI: https://doi.org/10.13303/j.cjbt.issn.1004-549x.2023.09.005
Journal volume & issue: Vol. 36, no. 9
pp. 777 – 781

Abstract

Read online

Objective To investigate the correlation between early immune reconstitution and clinical outcomes in patients with acute lymphoblastic leukemia (ALL) underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The basic information and treatment data of 99 patients with ALL undering allo-HSCT from December 2018 to February 2022 were collected. The proportions of CD3+ T, CD3+CD4+ T, CD3+CD8+ T and CD3-CD16+CD56+ NK cells were detected before and 30, 60 and 90 days after transplantation using flow cytometry. The correlation between early cellular immune reconstitution and neutrophil engraftment, platelet engraftment, infection, and acute and chronic graft-versus-host disease (GVHD) was analyzed. Results Among 99 ALL patients, the median time of neutrophil engraftment was day +11 (range, 8-28), and the median time of platelet engraftment was day +14 (range, 10-120). The cumulative incidence of blood stream infection (BSI) was 11.10% and the cumulative incidence of CMV within 100 days of transplantation was 40.40%. The cumulative incidence of EBV within 100 days was 7.10%. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 22.30%. The cumulative incidence of chronic graft-versus-host disease (cGVHD) within 1 year of transplantation was 16.20%. 1 -year cumulative relapse rate was 13.84%. The 1 -year cumulative disease-free survival (DFS) for all patients was 80.60% and the 1-year overall survival (OS) was 90.30%. The CD4+/CD8+ ratio was positively associated with the development of aGVHD at 30 days post-transplant (OR 1.21, 95CI 1.01-1.45, P<0.05). The proportion of CD16+ CD56+ NK cell were higher in the group without BSI than that in the BSI group before and 30 days after transplantation (P < 0.05). The proportion of CD4+ T-cell were lower in the CMV infection group than that in the group without CMV infection at 60 and 90 days post-transplant(P<0.05). The higher level of CD4+ T-cells at 60 days post-transplant was a protective factor for CMV infection within 100 days (HR 0.91, 95CI 0.84-0.99, P<0.05). Conclusion Early immune reconstitution after allo-HSCT in patients with ALL is associated with aGVHD, CMV and BSI.

Published in Zhongguo shuxue zazhi

ISSN: 1004-549X (Print)
Publisher: Institute of Blood Transfusion of Chinese Academy of Medical Sciences
Country of publisher: China
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the blood and blood-forming organs
Website: https://www.cjbt.cn/homeNav?lang=en

About the journal

Abstract

Keywords