Natural killer cell activity influences outcome after T cell depleted stem cell transplantation from matched unrelated and haploidentical donors

Lytic activity and recovery of natural killer (NK) cells was monitored in pediatric patients with leukemias (ALL, AML, CML, JMML) and myelodysplastic syndromes after transplantation of T cell depleted stem cells from matched unrelated ( n  = 18) and mismatched related (haploidentical, n  = 29) donor...

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Published in:Best practice & research. Clinical haematology 2011-09, Vol.24 (3), p.403-411
Main Authors: Lang, Peter, MD, PhD, Pfeiffer, Matthias, MD, Teltschik, Heiko-Manuel, MD, Schlegel, Patrick, MD, Feuchtinger, Tobias, MD, PhD, Ebinger, Martin, MD, Klingebiel, Thomas, MD, PhD, Bader, Peter, MD, PhD, Schlegel, Paul-Gerhard, MD, PhD, Beck, James, MD, PhD, Greil, Johann, MD, PhD, Handgretinger, Rupert, MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Antigens, CD34 - immunology
Child
Child, Preschool
Female
Follow-Up Studies
haploidentical
Hematologic Neoplasms - immunology
Hematologic Neoplasms - therapy
Hematology, Oncology and Palliative Medicine
Humans
K562 Cells
Killer Cells, Natural - immunology
leukemia
Lymphocyte Depletion
Male
natural killer
Peripheral Blood Stem Cell Transplantation
Recurrence
relapse
Time Factors
Tissue Donors
transplantation
Transplantation, Homologous
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Summary:Lytic activity and recovery of natural killer (NK) cells was monitored in pediatric patients with leukemias (ALL, AML, CML, JMML) and myelodysplastic syndromes after transplantation of T cell depleted stem cells from matched unrelated ( n  = 18) and mismatched related (haploidentical, n  = 29) donors. CD34 + selection with magnetic microbeads resulted in 8 × 103 /kg residual T cells. No post-transplant immune suppression was given. NK cells recovered rapidly after transplantation (300 CD56+/μL at day 30, median), whereas T cell recovery was delayed (median: 12 CD3+/μL at day 90). NK activity was measured as specific lysis of K 562 targets several times (mean: 3 assays per patient). Four temporal patterns of lytic activity could be differentiated: consistently low, consistently high, decreasing and increasing activity. Patients with consistently high or increasing activity had significantly lower relapse probability than patients with consistently low or decreasing levels (0.18 vs 0.73 at 2 years, p  
ISSN:1521-6926
1532-1924
DOI:10.1016/j.beha.2011.04.009