TY - JOUR
T1 - Monocyte Subpopulation Recovery as Predictors of Hematopoietic Cell Transplantation Outcomes
AU - Turcotte, Lucie M.
AU - Cao, Qing
AU - Cooley, Sarah A.
AU - Curtsinger, Julie
AU - Holtan, Shernan G.
AU - Luo, Xianghua
AU - Yingst, Ashely
AU - Weisdorf, Daniel J.
AU - Blazar, Bruce R.
AU - Miller, Jeffrey S.
AU - Wagner, John E.
AU - Verneris, Michael R.
N1 - Publisher Copyright:
© 2019 American Society for Blood and Marrow Transplantation
PY - 2019/5
Y1 - 2019/5
N2 - Monocyte recovery after hematopoietic cell transplantation (HCT)has been correlated with overall survival (OS). However, monocytes are heterogeneous and consist of classic (CD14 ++ CD16 - ), intermediate (CD14 + CD16 + ), and nonclassic (CD14 + CD16 ++ )subpopulations, with unique functional properties. We hypothesized that monocyte subpopulation reconstitution would vary based on allogeneic stem cell source and would be associated with outcomes. We studied monocyte subpopulation recovery at days 28, 60, 100, 180, and 365 post-HCT among 202 patients with hematologic malignancy. Significant differences in absolute monocyte count (AMC)and monocyte subpopulation counts at days 60 and 100 were identified based on stem cell source (all P <.01), with more robust recovery in umbilical cord blood (UCB)recipients. Using 2-fold cross-validation, optimal cutpoints were calculated for day 28 AMC and monocyte subpopulations based on OS. These were used to calculate hazard ratios for OS, disease-free survival (DFS), relapse, transplant-related mortality (TRM), and acute and chronic graft-versus-host disease. OS and DFS were superior when AMC and classic monocyte recovery were above optimal cutpoints (all P <.03). Relapse was reduced for those with AMC (P <.01)and classic (P =.05)monocyte counts above optimal cutpoints. TRM was also reduced when classic (P =.02)monocyte count exceeded optimal cutpoints. Intermediate and nonclassic monocyte recovery were not associated with outcomes. In summary, hematopoietic cell source is associated with monocyte subpopulation recovery, with the early robust recovery in UCB recipients. Recovery of AMC and classic monocytes were prognostic for survival, relapse, and TRM. These indicators may identify patients at increased risk for post-HCT failure and guide therapeutic interventions.
AB - Monocyte recovery after hematopoietic cell transplantation (HCT)has been correlated with overall survival (OS). However, monocytes are heterogeneous and consist of classic (CD14 ++ CD16 - ), intermediate (CD14 + CD16 + ), and nonclassic (CD14 + CD16 ++ )subpopulations, with unique functional properties. We hypothesized that monocyte subpopulation reconstitution would vary based on allogeneic stem cell source and would be associated with outcomes. We studied monocyte subpopulation recovery at days 28, 60, 100, 180, and 365 post-HCT among 202 patients with hematologic malignancy. Significant differences in absolute monocyte count (AMC)and monocyte subpopulation counts at days 60 and 100 were identified based on stem cell source (all P <.01), with more robust recovery in umbilical cord blood (UCB)recipients. Using 2-fold cross-validation, optimal cutpoints were calculated for day 28 AMC and monocyte subpopulations based on OS. These were used to calculate hazard ratios for OS, disease-free survival (DFS), relapse, transplant-related mortality (TRM), and acute and chronic graft-versus-host disease. OS and DFS were superior when AMC and classic monocyte recovery were above optimal cutpoints (all P <.03). Relapse was reduced for those with AMC (P <.01)and classic (P =.05)monocyte counts above optimal cutpoints. TRM was also reduced when classic (P =.02)monocyte count exceeded optimal cutpoints. Intermediate and nonclassic monocyte recovery were not associated with outcomes. In summary, hematopoietic cell source is associated with monocyte subpopulation recovery, with the early robust recovery in UCB recipients. Recovery of AMC and classic monocytes were prognostic for survival, relapse, and TRM. These indicators may identify patients at increased risk for post-HCT failure and guide therapeutic interventions.
KW - HCT outcomes
KW - Monocyte subpopulations
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U2 - 10.1016/j.bbmt.2019.01.003
DO - 10.1016/j.bbmt.2019.01.003
M3 - Article
C2 - 30625388
AN - SCOPUS:85061138475
SN - 1083-8791
VL - 25
SP - 883
EP - 890
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -
