Association between Thymic Function and Allogeneic Hematopoietic Stem Cell Transplantation Outcome: Results of a Pediatric Study

被引:10
作者
Saglio, Francesco [1 ]
Cena, Silvia [2 ,3 ]
Berger, Massimo [1 ]
Quarello, Paola [1 ]
Boccasavia, Viola [2 ,3 ]
Ferrando, Federica [2 ,3 ]
Pittana, Laura [1 ]
Bruno, Benedetto [2 ,3 ]
Fagioli, Franca [1 ]
机构
[1] Osped Infantile Regina Margherita, AOU Citta Salute & Sci Torino, Pediat Oncohematol Stem Cell Transplantat & Cellu, I-10126 Turin, Italy
[2] Univ Turin, AOU Citta Salute & Sci Torino, Div Hematol, Turin, Italy
[3] Univ Turin, Dept Mol Biotechnol & Hlth Sci, Turin, Italy
关键词
sjTREC; Allogeneic hematopoietic stem cell transplantation; Pediatric; BONE-MARROW-TRANSPLANTATION; RECEPTOR EXCISION CIRCLES; IMMUNE RECONSTITUTION; CORD BLOOD; REGENERATION; CHILDREN; QUANTIFICATION; COMPARTMENT; REPERTOIRE; PREDICTION;
D O I
10.1016/j.bbmt.2015.02.010
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Robust T cell function recovery has been shown to be crucial in determining allogeneic hematopoietic stern cell transplantation (HSCT) outcome, and there is growing evidence that the thymus plays a central role in regulating this process. We performed a long-term analysis of the role of thymic activity recovery in a population of pediatric patients undergoing allogeneic HSCT by signal joint T cell receptor excision circle (sjTREC) quantification. In this study, characterized by a long-term follow-up (median. 72 months), we found patients with higher levels of sjTRECs before transplantation had a statistically significant reduced risk of death compared with patients with lower values (relative risk,.31; 95% confidence interval,.30 to .32; P = .02), showing this different outcome was mainly related to a reduction of relapse incidence (14% versus 43%. P = .02). Unlike previous reports, we observed no correlation between sjTREC levels and lymphocyte recovery. Moreover, we confirmed that only graft-versus-host disease influenced thymic activity after transplantation. In conclusion, our results suggest an association between pretransplantation thymic activity and the long-term outcome of pediatric patients undergoing HSCT, mainly through a reduction of relapse opportunities. (C) 2015 American Society for Blood and Marrow Transplantation.
引用
收藏
页码:1099 / 1105
页数:7
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