Impact of plasmacytoid dendritic cells on outcome after reduced-intensity conditioning allogeneic stem cell transplantation

M Mohty, D Blaise, C Faucher, VJ Bardou, JA Gastaut… - Leukemia, 2005 - nature.com
M Mohty, D Blaise, C Faucher, VJ Bardou, JA Gastaut, P Viens, D Olive, B Gaugler
Leukemia, 2005nature.com
The reconstitution of the plasmacytoid dendritic cells (PDCs) compartment might influence
outcome after allogeneic stem cell transplantation (allo-SCT). Thus, we investigated the
impact of blood PDCs measured at the third month after reduced-intensity conditioning (RIC)
in 54 patients who received an HLA-identical sibling allo-SCT. The absence of grade II–IV
acute graft-versus-host-disease (GVHD) was associated with an improved PDC count at 3
months after RIC-allo-SCT (P= 0.003; OR= 6.4; 95% CI, 1.9–22). The CD34+ stem cell dose …
Abstract
The reconstitution of the plasmacytoid dendritic cells (PDCs) compartment might influence outcome after allogeneic stem cell transplantation (allo-SCT). Thus, we investigated the impact of blood PDCs measured at the third month after reduced-intensity conditioning (RIC) in 54 patients who received an HLA-identical sibling allo-SCT. The absence of grade II–IV acute graft-versus-host-disease (GVHD) was associated with an improved PDC count at 3 months after RIC-allo-SCT (P= 0.003; OR= 6.4; 95% CI, 1.9–22). The CD34+ stem cell dose and other lymphoid subsets infused with the allograft did not affect PDC recovery. Although PDC count could not predict death from progression or relapse, patients with a ‘high’PDC recovery profile had an improved overall survival (OS; P= 0.03), in contrast to patients with a ‘low’PDC recovery profile who had an increased incidence of nonrelapse mortality (GVHD, infections)(P= 0.03). The overall incidence of late infections (viral, fungal and bacterial) was significantly higher in the ‘low’PDC recovery group as compared to the ‘high’PDC recovery group (59 vs 19%; P= 0.002). In a multivariate analysis, only a ‘high’PDC count was significantly predictive of a decreased risk of death (P= 0.04; RR= 0.34; 95% CI, 0.12–0.96). Monitoring of PDCs at 3 months after RIC-allo-SCT may be a useful indicator predictor of long-term outcome.
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