uu.seUppsala University Publications
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Effect of Graft-versus-Host Disease Prophylaxis Regimens on T and B Cell Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation
Karolinska Univ Hosp, Cell Therapy & Allogene Stem Cell Transplantat, Stockholm, Sweden;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.
Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.ORCID iD: 0000-0002-5277-5129
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden;Uppsala Univ Hosp, Clin Res & Dev Unit, Uppsala, Sweden.ORCID iD: 0000-0003-0520-4312
Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
Show others and affiliations
2019 (English)In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 6, p. 1260-1268Article in journal (Refereed) Published
Abstract [en]

Lymphocyte reconstitution is pivotal for successful long-term outcome after allogeneic hematopoietic stem cell transplantation (HSCT), and conditioning regimen and post-transplantation immunosuppression are risk factors for prolonged immunodeficiency. Nevertheless, the effects of different immunosuppressive protocols on lymphocyte output and replicative capacity have not been investigated. Here we assessed T cell receptor excision circles (TREC), kappa-deleting recombination excision circles (KREC), and T cell telomere length (TL) as proxy markers for immune reconstitution in patients in a prospective randomized trial comparing graft-versus-host disease (GVHD) prophylaxis after transplantation (cyclosporine/methotrexate versus tacrolimus/sirolimus; n=200). Results showed that medians of TREC, KREC, and TL were not significantly different between the prophylaxis groups at any assessment time point during follow-up (24 months), but the kinetics of TREC, KREC, and TL were significantly influenced by other transplantation-related factors. Older recipient age, the use of antithymocyte globulin before graft infusion, and use of peripheral blood stem cell grafts were associated with lower TREC levels, whereas acute GVHD transiently affected KREC levels. Patients with lymphocyte excision circle levels above the median at <= 6 months post-transplantation had reduced transplantation-related mortality and superior 5-year overall survival (P<.05). We noticed significant T cell telomere shortening in the patient population as a whole during follow-up. Our results suggest that lymphocyte reconstitution after transplantation is not altered by different immunosuppressive protocols. This study has been registered at ClinicalTrials.gov (identifier: NCT00993343). (C) 2019 American Society for Blood and Marrow Transplantation.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 25, no 6, p. 1260-1268
Keywords [en]
Allogeneic hematopoietic stem cell transplantation, Immune reconstitution, Clinical trial, GVHD prophylaxis, Lymphocyte excision circles
National Category
Hematology Immunology
Identifiers
URN: urn:nbn:se:uu:diva-390588DOI: 10.1016/j.bbmt.2019.01.029ISI: 000472986900027PubMedID: 30710687OAI: oai:DiVA.org:uu-390588DiVA, id: diva2:1342407
Funder
Swedish Research Council, VR 2016-00516Swedish Cancer Society, CAN 2016/747Swedish Childhood Cancer Foundation, BCF PR2015-0120Swedish Childhood Cancer Foundation, BCF PR2017-0016Stockholm County CouncilAvailable from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13Bibliographically approved

Open Access in DiVA

fulltext(1058 kB)4 downloads
File information
File name FULLTEXT01.pdfFile size 1058 kBChecksum SHA-512
f07cdff88fc67b656fcf10b0d0ffbc2d7344d193e43c9c210671eb2d790bf3ebbb3576ca7fc5f4c01a95e6626de36acc77176b466d6096402d9987e2e840d93e
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Gaballa, AhmedRemberger, MatsUhlin, Michael
By organisation
Department of Medical Sciences
In the same journal
Biology of blood and marrow transplantation
HematologyImmunology

Search outside of DiVA

GoogleGoogle Scholar
Total: 4 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 5 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf