PMID- 14962904
OWN - NLM
STAT- MEDLINE
DCOM- 20040708
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 103
IP  - 11
DP  - 2004 Jun 1
TI  - Low dendritic cell count after allogeneic hematopoietic stem cell transplantation 
      predicts relapse, death, and acute graft-versus-host disease.
PG  - 4330-5
AB  - Dendritic cells (DCs) are key antigen-presenting cells with a potential role in 
      tumor vaccines. We investigated the hypothesis that early reconstitution of DCs 
      after allogeneic hematopoietic stem cell transplantation (SCT) improves survival. 
      We also correlated DC reconstitution with complications of relapse and acute 
      graft-versus-host disease (aGVHD). Fifty patients underwent transplantation 
      between February 2000 and March 2003, with a median follow-up of 501 days (range, 
      136-1263 days). Most (92%) received blood stem cells, and the remainder received 
      bone marrow from HLA-matched sibling donors for predominantly high-risk 
      hematologic malignancies. Around the time of engraftment, peripheral blood 
      underwent flow cytometry analysis for DCs, and the cells were divided as DC1 and 
      DC2. Using Kaplan-Meier analysis, patients with lower DC counts (< 4.97 
      cells/microL) were found to have significantly worse survival (P =.002), 
      increased incidence of relapse (P =.002), higher incidence of aGVHD onset (P 
      =.0005), and a composite end point of relapse or death (P =.0017). A Cox 
      proportional hazards multivariate model adjusted for important covariates 
      confirmed that low DC count is independently associated with death (hazard ratio 
      [HR], 3.8; P =.02), time to relapse (HR, 11.6; P =.001), and aGVHD (HR, 3.3; P 
      =.04). Sensitivity and specificity rates for low DC count in predicting death or 
      relapse are 73% and 75%, respectively. Low numbers of circulating DCs 
      significantly increase the risk for relapse and acute GVHD and predict death 
      after allogeneic SCT.
FAU - Reddy, Vijay
AU  - Reddy V
AD  - Division of Hematology/Oncology, University of Florida College of Medicine, 1600 
      SW Archer Rd, Gainesville, FL 32610, USA. reddyvs@medicine.ufl.edu
FAU - Iturraspe, Jose A
AU  - Iturraspe JA
FAU - Tzolas, Alessandra C
AU  - Tzolas AC
FAU - Meier-Kriesche, Herwig-Ulf
AU  - Meier-Kriesche HU
FAU - Schold, Jesse
AU  - Schold J
FAU - Wingard, John R
AU  - Wingard JR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20040212
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Cell Count
MH  - Dendritic Cells/*cytology
MH  - Disease-Free Survival
MH  - Female
MH  - Graft vs Host Disease/diagnosis/*mortality
MH  - Hematopoietic Stem Cell Transplantation/*mortality
MH  - Humans
MH  - Immunophenotyping
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Recurrence
MH  - Survival Analysis
EDAT- 2004/02/14 05:00
MHDA- 2004/07/09 05:00
CRDT- 2004/02/14 05:00
PHST- 2004/02/14 05:00 [pubmed]
PHST- 2004/07/09 05:00 [medline]
PHST- 2004/02/14 05:00 [entrez]
AID - S0006-4971(20)55433-5 [pii]
AID - 10.1182/blood-2003-09-3325 [doi]
PST - ppublish
SO  - Blood. 2004 Jun 1;103(11):4330-5. doi: 10.1182/blood-2003-09-3325. Epub 2004 Feb 
      12.