Background

Cytokine storm described in patients after allogeneic haematopoietic stem cell transplantation (alloHSCT) is associated with the appearance of CD14 + HLADR - in the blood.

Methods

To study the role of CD14 + HLADR - cells 223 patients after alloHSCT followed from 1 month to 15 years. The methods used included flow cytometry for blood cells profiling, nucleic acid tests for viral reactivation, and physician care according to the Polish and international guidelines.

Results

We found that CD14 + HLADR - peak values determined during the first 60 post-transplant days were higher in the patients who died than in those who survived in this time interval (mean ± SEM: 3.78 ± 0.67% vs 2.38 ± 0.65%, p < 0.001). Receiver operating characteristic (ROC) analysis showed that CD14 + HLADR - cells level in the blood at cut-off point at 0.71% discriminated the patients as to survival; the patients above the threshold had poorer survival (Kaplan-Meier curve covering 15-year observation) than those below (0.19 vs 0.46, p < 0.001). Infections prevailed other causes of death in the high blood CD14 + HLADR - group (0.61 vs 0.38, p = 0.057). ROC analysis defined the CD4+ blood level at 17.70% as not significantly associated with survival. Multivariate analysis revealed that CD14 + HLADR - cells (HR = 3.47, p < 0.001) and the presence of acute graft-versus-host disease (aGvHD) grade ≥ 3 (HR = 3.82, p = 0.005) adversely impacted the survival.

Conclusions

CD14 + HLADR - cells can serve as a biomarker for the risk of fatal complications frequently associated with infections.

中文翻译：

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CD14 + HLADR - alloHSCT 后患者的血液值高度预测生存和感染并发症

背景

在同种异体造血干细胞移植 (alloHSCT) 后患者中描述的细胞因子风暴与血液中 CD14 + HLADR - 的出现有关。

方法

为了研究 CD14 + HLADR - 细胞在 alloHSCT 后 1 个月至 15 年的 223 名患者的作用。使用的方法包括用于血细胞分析的流式细胞术、用于病毒再激活的核酸测试以及根据波兰和国际指南的医生护理。

结果

我们发现，在移植后前 60 天内，死亡患者的 CD14 + HLADR - 峰值高于在此时间间隔内存活的患者（平均值 ± SEM：3.78 ± 0.67% vs 2.38 ± 0.65%，p  < 0.001)。接受者操作特征 (ROC) 分析表明，CD14 + HLADR - 细胞水平在 0.71% 的截止点处可区分患者的生存率；高于阈值的患者的生存率（涵盖 15 年观察的 Kaplan-Meier 曲线）比低于阈值的患者更差（0.19 vs 0.46，p  < 0.001）。在高血 CD14 + HLADR - 组中感染占主导地位的其他死因（0.61 vs 0.38，p = 0.057)。ROC 分析将 17.70% 的 CD4+ 血液水平定义为与生存率无显着相关性。多变量分析显示，CD14 + HLADR - 细胞 (HR = 3.47, p  < 0.001) 和急性移植物抗宿主病 (aGvHD) ≥ 3 级 (HR = 3.82, p  = 0.005) 对生存产生不利影响。

结论

CD14 + HLADR - 细胞可以作为经常与感染相关的致命并发症风险的生物标志物。