CD4(+) CD28(+) lymphocytes on day 5 after high-dose melphalan for multiple myeloma predict a low risk of infections during severe neutropenia and are associated with the number of reinfused T lymphocytes of the autologous stem cell graft |
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| Authors: | Schmidmaier Ralf Then Cornelia Schnabel Brigitte Oduncu Fuat Baumann Philipp Straka Christian |
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| Affiliation: | 1. Department of Haematology and Oncology, Medizinische Klinik Innenstadt, Klinikum der Universität München (LMU), Munich, Germany;2. Schön Klinik Starnberger See, Berg, Germany;1. Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany;2. CRC Homburg, Collaborative Research Centre, AO Foundation, Saarland University, Homburg, Germany;3. Department of Anatomy and Cell Biology, Saarland University, Homburg, Germany;1. Department of Hematology, General Hospital of the Air Force, Beijing, China;2. Department of Experimental Hematology, Beijing Institute of Radiation Medicine, Beijing, China;1. DRK Blood Service Baden-Württemberg-Hessia, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm and Institute of Transfusion Medicine, University of Ulm, Ulm, Germany;2. Max-Planck-Institute for Polymer Research, Mainz, Germany;3. INSERM U917, Université Rennes 1, Faculté de Médecine, Rennes, France;4. Pôle Cellules et Tissus, CHU Pontchaillou, Rennes, France;5. DRK Blood Service Baden-Württemberg-Hessia, Institute of Transfusion Medicine and Immuno haematology, Frankfurt, Germany;6. University of Ulm, Department of Internal Medicine II, Ulm, Germany;1. Manipal Institute of Regenerative Medicine, Constituent Institute of Manipal University, Bangalore, Karnataka, India;2. Department of Biophysics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India |
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| Abstract: | Background aimsNeutropenia following high-dose chemotherapy is associated with a substantial risk of infectious complications. The aim of this study was to identify variables in residual leukocyte subsets during neutropenia that are predictive for neutropenic fever.MethodsResidual leukocytes in the peripheral blood on day 5 after autologous blood stem cell transplantation were analyzed by three-color flow cytometry in 55 consecutive patients with multiple myeloma. Furthermore, the number of T cells transfused with the autografts was determined.ResultsNeutrophil counts at day 5 and neutrophil engraftment were similar in patients with and without neutropenic fever. Low absolute lymphocyte, CD4+ CD28+ and CD45RO+ CD28+ counts at day 5 were associated with neutropenic fever. T-cell counts at day 5 correlated with the CD3+ cell number in the graft.ConclusionsOur data show that the absolute lymphocyte, CD4+ CD28+ and CD45RO+ CD28+ counts play a role in host defense during severe neutropenia. The T-cell number in the graft may help to identify patients at high risk of neutropenic infections. |
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