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Immune reconstitution dynamics after unrelated allogeneic transplantation with post-transplant cyclophosphamide compared to classical immunosuppression with anti-thymocyte globulin: a prospective cohort study.
Kerbauy, Mariana Nassif; Rocha, Fernanda Agostini; Arcuri, Leonardo Javier; Cunegundes, Priscila Silva; Kerbauy, Lucila Nassif; Machado, Clarisse Martins; Ribeiro, Andreza Alice Feitosa; Banerjee, Pinaki P; Marti, Luciana Cavalheiro; Hamerschlak, Nelson.
Afiliación
  • Kerbauy MN; Department of Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, Sao Paulo. mariana.kerbauy@einstein.br.
  • Rocha FA; Instituto Israelita de Ensino e Pesquisa (IIEP), Hospital Israelita Albert Einstein, Sao Paulo, SP.
  • Arcuri LJ; Department of Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, Sao Paulo.
  • Cunegundes PS; Instituto Israelita de Ensino e Pesquisa (IIEP), Hospital Israelita Albert Einstein, Sao Paulo, SP.
  • Kerbauy LN; Department of Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, Sao Paulo.
  • Machado CM; Instituto Israelita de Ensino e Pesquisa (IIEP), Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil; Virology Laboratory, Institute of Tropical Medicine, University of Sao Paulo, Sao Paulo.
  • Ribeiro AAF; Department of Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, Sao Paulo.
  • Banerjee PP; The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Marti LC; Instituto Israelita de Ensino e Pesquisa (IIEP), Hospital Israelita Albert Einstein, Sao Paulo, SP.
  • Hamerschlak N; Department of Hematology and Bone Marrow Transplantation, Hospital Israelita Albert Einstein, Sao Paulo.
Haematologica ; 2024 Sep 12.
Article en En | MEDLINE | ID: mdl-39279428
ABSTRACT
Post-transplant cyclophosphamide has contributed to the success of haploidentical hematopoietic stem cell transplantation (HSCT) and is also been used in transplantation from matched donors. However, limited data on the immune reconstitution after this type of immunosuppression is available. We aimed to evaluate immune reconstitution after HSCT from unrelated donors, comparing anti-thymocyte globulin (ATG) and post-transplant cyclophosphamide (PTCy). Consecutive patients undergoing HSCT from unrelated donors and receiving either ATG or PTCy were prospectively included. Immune reconstitution analyses were performed by flow cytometry pre transplant and on days 30, 60, 90, and 180 post-transplant. We included 36 patients, 20 in the ATG group and 16 in the PTCy group. In the early post-transplant period (D+30), the ATG group showed a higher number of total lymphocytes, T, B, and NK cells compared to the PTCy group. However, at D+180, the PTCy group exhibited a higher number of B cells. On D+60 and D+90, the ATG group displayed higher number of NK cells CD56dim compared to the PTCy group, while on D+180, the PTCy group showed higher number of CD56neg, CD16pos, and, NKG2Dpos NK cells. Naive CD4+, transition CD4+, and naive CD8+ T cells on D+60 were identified as risk factors for acute graft-versus-host disease (GVHD) grades II-IV, and a higher count of CD4+ memory cells on D+180 was identified as a risk factor for chronic GVHD. In the context of unrelated allogeneic transplantation, immunosuppression with PTCy was associated with later B, T and NK cells reconstitution compared to ATG.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Haematologica Año: 2024 Tipo del documento: Article Pais de publicación: Italia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Haematologica Año: 2024 Tipo del documento: Article Pais de publicación: Italia