Association With the Presence of Naive T Cells in Chronic Myeloid Leukemia Patients After Allogeneic Human Stem Cell Transplantation and the Lower Incidence of Chronic Graft-Versus Host Disease and Relapse

• Published in: Transplantation proceedings 2007-11, Vol.39 (9), p.2898-2901
• Main Authors: Wysoczanska, B, Bogunia-Kubik, K, Dlubek, D, Jaskula, E, Sok, A, Drabczak-Skrzypek, D, Sedzimirska, M, Lange, A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antigens, CD - blood; Biological and medical sciences; Bone Marrow Transplantation - immunology; Child; Chronic Disease; Female; Flow Cytometry; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft vs Host Disease - immunology; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - immunology; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphocyte Count; Male; Medical sciences; Middle Aged; Recurrence; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; T-Lymphocytes - immunology; T-Lymphocytes, Regulatory - immunology; Tissue, organ and graft immunology; Transplantation Chimera; Transplantation, Homologous - immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.08.036

Abstract Introduction Allotransplantation in chronic myeloid leukemia (CML) patients offers long-lasting remissions, which largely depend on immunologic surveillance of alloreactivity. Alloreactivity in CML patients has a durable potential. However a large proportion of relapsing patients, who have to undergo donor lymphocyte treatment is still abundant. Methods We studied a group of 31 CML patients post allogeneic transplantation for their level of T-cell receptor excision circles (TREC) and proportion of naive and memory/effector T cells in the peripheral blood (PB). TREC numbers were determined by quantitative PCR (qPCR) and T-cell subsets CD4+ CD27+ CD45RO− , CD4+ CD27− CD24RO+ , CD4+ CCR7+ , and CD4+ CCR7− by flow cytometry. Patients were analyzed for posttransplant chimerism, type of bcr-abl transcripts, and number of TREC in association with the presence of chronic graft-versus-host disease (cGVHD) and relapse. CML patients with TREC+ in PB had a higher proportion of CD4+ CD27+ CD45RO− cells (3.54 vs 2.45%; P = .105) and CD4+ CCR7+ cells (4.85 vs 2.67%; P = .007), and a lower proportion of CD4+ CD27− CD45RO+ cells (5.55 vs 9.09%; P = .037). The incidence of cGvHD was reduced among TREC+ CML patients (3/14 vs 11/17; P = .006). Results The 5 out of 31 CML patients who relapsed were characterized by the presence of b2a2, b3/a2 or both type of transcripts, a lack of TREC in the blood, and a lower proportion of naïve and effector/memory T cells. No association was observed between any of HLA specificities, type of bcr-abl transcripts and incidence of relapse. Conclusion The presence of TREC is affected by chronic GvHD; TREC negativity may constitute a risk of mixed chimerism and relapse.