Large Granular Lymphocyte Expansion after Allogeneic Hematopoietic Stem Cell Transplant Is Associated with a Cytomegalovirus Reactivation and Shows an Indolent Outcome

被引:29
作者
Nann-Ruetti, Sabine [1 ]
Tzankov, Alexander [2 ]
Cantoni, Nathan [1 ]
Halter, Joerg [1 ]
Heim, Dominik [1 ]
Tsakiris, Dimitrios [1 ]
Arber, Caroline [1 ]
Buser, Andreas [1 ]
Gratwohl, Alois [1 ]
Tichelli, Andre [1 ]
Rovo, Alicia [1 ]
机构
[1] Univ Basel Hosp, Dept Hematol, CH-4031 Basel, Switzerland
[2] Univ Basel Hosp, Dept Pathol, CH-4031 Basel, Switzerland
关键词
LGL; CMV; Stem cell transplant; GVHD; BONE-MARROW-TRANSPLANTATION; T-CELLS; LYMPHOPROLIFERATIVE DISORDERS; RENAL-TRANSPLANTATION; DONOR ORIGIN; LEUKEMIA; INFECTION; RECIPIENTS; KILLER; CD8(+);
D O I
10.1016/j.bbmt.2012.07.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Expansions of CD3+ large granular lymphocytes (LGLs) after allogeneic hematopoietic stem cell transplantation (HSCT) have been described. We sought to evaluate incidence, characteristics, and clinical significance of persistent T cell (T-)LGL after HSCT. Fourteen of 215 recipients (7%) were diagnosed with LGL expansions. Thirteen showed a CD3+/CD8+ immunophenotype, 5 of them with clonal TCR-gamma rearrangement. The lymphocytes appeared at a median of 16 months (range, 3-58 months) after HSCT and lasted for a median time of 31 months (range, 2-179 months). Cytomegalovirus (CMV) reactivation (P = .001) and acute graft-versus-host disease (aGVHD) were associated with LGL expansion (P = .02). In the multivariate analysis, only CMV reactivation showed a significant association with T-LGL expansion (relative risk [RR]: 5.063; 95% confidence interval [CI]: 1.586-16.160; P =.006). The observed posttransplantation LGL expansions, even if monoclonal, showed a chronic, indolent course. Our data indicate that such expansions may be considered as an expression of chronic stimulation, triggered by CMV reactivation rather than a malignant transformation. Biol Blood Marrow Transplant 18: 1765-1770 (2012) (C) 2012 American Society for Blood and Marrow Transplantation
引用
收藏
页码:1765 / 1770
页数:6
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