Blood: Post-HCT CD4-T cell reconstruction predicts survival prognostics in patients with acute GvHD

Acute graft anti-host disease (aGvHD) is a life-threatening complication that causes high mortality after hematogenesic cell transplantation (HCT).
a variety of options have been applied to prevent the occurrence of aGvHD, aGvHD is still very common, affecting about 20-60% of patients with heterogeneity HCT.
previous studies have shown that early CD4-T cell reconstruction (CD4-IR) can predict survival after HCT in patients.
the study, Coco and others studied the correlation between cd4-IR and survival rates in patients with aGvHD after HCT.
included child patients who received the first isogenetic HCT at two separate centers (UMC/PMC and MSK).
the main prognosmation indicators are recurrence-free mortality (NRM) and total survival (OS), layered according to aGvHD and CD4-IR.
apply a Multivariate and Event Time Cox Scale Risk Model.
the non-recurrence mortality and overall survival rate of patients with CD4-IR iii-IV aGvHD were included in 591 patients (UMC/PMC 276 and MSK 315) within 100 days of HCT.
for patients with III-IV class aGvHD with or without CD4-IR within 100 days of HCT, the NRM of UMC/PMC was 30% vs 80% (P=0.02) and MSK NRM was 5% vs 67% (P=0.02).
addition, CD4-plus IR is associated with low OS; 61% vs 20% vs. 20% vs. MSK group vs 33% (p-0.12) for patients with CD4 plus IR in the UMC/PMC group.
adGvHD pre-onset CD4-IR deficiency was associated with a significant increase in NRM (74% vs. 12%), and poor OS (24% vs 78%) (p.lt;0.001).
review, the researchers demonstrated that simple and powerful predictions of the prognostic markers of HCT in patients -- early CD4 plus IR -- were associated with survival rates in patients with moderate to severe aGvHD.
the study suggests that strategies to improve T-cell recovery after HCT may affect survival rates in patients with aGvHD.
results need to be further validated through forward-looking trials.