Cytotoxic T lymphocyte precursor frequency as a predictor of acute graft-versus-host disease in bone marrow transplantation from HLA-identical siblings
P. Affaticati et al., Cytotoxic T lymphocyte precursor frequency as a predictor of acute graft-versus-host disease in bone marrow transplantation from HLA-identical siblings, BONE MAR TR, 26(5), 2000, pp. 517-523
Citations number
52
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
The measurement of precursor frequencies of donor anti-recipient cytotoxic
T lymphocytes (CTL-p) has been shown to predict the incidence and the sever
ity of acute graft-versus-host disease (aGVHD) in unrelated donor bone marr
ow transplantation (BR IT). In HLA-identical sibling BMT, where aGVHD is mo
st likely caused by minor histocompatibility antigen mismatches, this assay
did not appear to be sensitive enough to provide similar predictive inform
ation. In this study, the CTL-p frequencies and the incidence and severity
of aGVHD in 51 onco-hematological patients transplanted from HLA-identical
siblings were compared. Sibling donors were selected on the basis of HLA id
entity using serological typing for HLA-A, B, C antigens, whereas HLA-DRB w
as tested by molecular analysis. Sibling identity was also confirmed by DNA
heteroduplex analyses. Fifteen out of 21 (71%) patients with high precurso
r frequency (>1:100 x 10(3)) and 12 out of 30 (40%) with low precursor freq
uency (<1:100 x 10(3)) experienced clinically significant (II-IV) aGVHD. A
significant correlation (P = 0.04) between CTL-p frequency and severe aGVHD
was demonstrated. Moreover there was a positive trend for a high frequency
response according to an increasing grade of aGVHD, which was statisticall
y significant (P = 0.04). In our experience the CTL-p assay is a helpful pr
edictive test for aGVHD in HLA-identical sibling BMT, indicating high risk
patients possibly requiring additional prophylaxis.q351uf 3