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Peripheral Blood Plasmacytoid Dendritic Cells at Day 100 Can Predict Outcome after Allogeneic Stem Cell Transplantation

Abstract : The rapidly increasing use of allogeneic stem cell transplantation (allo-SCT) emphasizes the need for identifying variables predictive of its outcome. Plasmacytoid dendritic cells (pDCs) play a major role in establishing immune competence and in several autoimmune diseases. Thus, we investigated whether pDCs might influence the outcome of patients after allo-SCT in 79 consecutive patients who underwent this procedure. pDCs were identified in the blood of patients at day 100 after allo-SCT by staining peripheral blood mono-nuclear cells for surface markers and intracellular cytokines and analyzing them on a flow cytometer. We found the pDC level at day 100 was not influenced by patient or graft characteristics, and only the absence of previous grades II to IV acute graft-versus-host disease was significantly associated with higher levels of blood pDCs after allo-SCT (OR, .67; 95% CI, .54 to .83; P ¼ .0004). Using the median value of pDCs at day 100 to divide the patients into 2 distinct groups, we observed that a low pDC level was correlated with a worse overall survival (55% versus 86%, P ¼ .007). In a multivariate analysis, only low pDC level (OR, 3.41; 95% CI, 1.19 to 9.79; P ¼ .02) and older patient age (OR, 5.16; 95% CI, 1.15 to 23.14; P ¼ .03) were significantly predictive of increased risk of death. We conclude that monitoring of pDC may be useful for patient management and may have a significant impact on the probability of a favorable outcome of allo-SCT. INTRODUCTION Allogeneic stem cell transplantation (allo-SCT) has evolved into a curative therapy for a variety of hematological and nonhematological malignancies. In the treatment of the former, high-intensity conditioning therapy before allo-SCT eradicates malignant cells, and the infusion of donor stem cells enables reconstitution of the recipient's hematopoietic system and also triggers a graft-versus-leukemia (GVL) effect. However, the main limitation of treating a broader spectrum of diseases and patients with allo-SCT is graft-versus-host disease (GVHD), a reaction closely associated to GVL. Both GVHD and GVL occur when donor T lymphocytes respond to genetically defined proteins on host cells. Den-dritic cells (DCs) are key antigen-presenting cells that
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Zinaida Peric, Xavier Cahu, Florent Malard, Eolia Brissot, Patrice Chevallier, et al.. Peripheral Blood Plasmacytoid Dendritic Cells at Day 100 Can Predict Outcome after Allogeneic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation, Elsevier, 2015, 21 (8), pp.1431-1436. ⟨10.1016/j.bbmt.2015.04.003⟩. ⟨inserm-01285141⟩

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