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Blood, 15 March 2005, Vol. 105, No. 6, pp. 2608-2613. Prepublished online as a Blood First Edition Paper on November 16, 2004; DOI 10.1182/blood-2004-04-1667. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-04-1667v1 105/6/2608    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Clave, E. Articles by Toubert, A. Search for Related Content PubMed PubMed Citation Articles by Clave, E. Articles by Toubert, A. Related Collections Transplantation Immunobiology Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Prognostic value of pretransplantation host thymic function in HLA-identical sibling hematopoietic stem cell transplantation Emmanuel Clave, Vanderson Rocha, Kimmo Talvensaari, Marc Busson, Corinne Douay, Marie-Lorraine Appert, Claire Rabian, Maryvonnick Carmagnat, Federico Garnier, Alain Filion, Gérard Socié, Eliane Gluckman, Dominique Charron, and Antoine Toubert From the Laboratoire d'Immunologie et d'Histocompatibilité Assistance Publique-Hôpitaux de Paris (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM) U396, Institut Universitaire d'Hématologie, the Service d'Hématologie-Greffe de Moelle, Hôpital Saint-Louis, AP-HP, and INSERM ERM0220, Institut Universitaire d'Hématologie, Paris, France; and the Finnish Red Cross Blood Transfusion Service, Department of Tissue Typing, Finnish Bone Marrow Donor Registry, Helsinki, Finland. Thymic function is critical for immune reconstitution after hematopoietic stem cell transplantation (HSCT). We evaluated recipient thymic function before HSCT by quantifying T-cell receptor excision circles (TRECs) in pretransplantation peripheral blood lymphocytes from 102 patients who received HSCs from an HLA-identical sibling for malignant (n = 87) or nonmalignant diseases (n = 15). Median TREC value before transplantation was 257 TRECs per 150 000 CD3+ cells (range, 0-42 746). We assessed 172 TRECs per 150 000 CD3+ cells as the most discriminating TREC value for survival in a first cohort of patients (n = 62). This cut-off was validated in a second independent prospective group of 40 patients. In the 102 patients, a TREC value greater than or equal to 172 was associated with a better survival (P < .000 01), a decreased incidence of grade II-IV acute graft-versus-host disease (GVHD; P = .017), chronic GVHD (P = .023), and bacterial (P = .003) and cytomegalovirus (CMV) infection (P = .024). In a multivariate analysis, low pretransplantation TREC values were associated with a higher incidence of CMV infection (hazard ratio [HR] = 2.0, P = .06) and severe bacterial infections (HR = 2.8, P = .036). Finally, high TREC values (HR = 6.6, P = .002) and ABO compatibility (HR = 2.7, P = .02) were associated with a better survival. Therefore, recipient host thymic function assessment could be helpful in predicting HSCT outcome and identifying patients who require a close immunologic monitoring. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: E. Gluckman Immune reconstitution after unrelated cord blood transplants in adults Blood, December 15, 2007; 110(13): 4136 - 4136. [Full Text] [PDF] Y.-G. Yao, R. W. Childs, S. Kajigaya, J. P. McCoy Jr., and N. S. Young Mitochondrial DNA Sequence Heterogeneity of Single CD34+ Cells After Nonmyeloablative Allogeneic Stem Cell Transplantation Stem Cells, October 1, 2007; 25(10): 2670 - 2676. [Abstract] [Full Text] [PDF] M. Robin, S. Marque-Juillet, C. Scieux, R. P. de Latour, C. Ferry, V. Rocha, J.-M. Molina, A. Bergeron, A. Devergie, E. Gluckman, et al. Disseminated adenovirus infections after allogeneic hematopoietic stem cell transplantation: incidence, risk factors and outcome Haematologica, September 1, 2007; 92(9): 1254 - 1257. [Abstract] [Full Text] [PDF] Y. Sakoda, D. Hashimoto, S. Asakura, K. Takeuchi, M. Harada, M. Tanimoto, and T. Teshima Donor-derived thymic-dependent T cells cause chronic graft-versus-host disease Blood, February 15, 2007; 109(4): 1756 - 1764. [Abstract] [Full Text] [PDF]

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