Lymphocyte counts may predict a good response to mesenchymal stromal cells therapy in graft versus host disease patients

PLoS One. 2019 Jun 12;14(6):e0217572. doi: 10.1371/journal.pone.0217572. eCollection 2019.

Abstract

Steroid-resistant GvHD is one of the most significant causes of mortality following allogeneic Hematopoietic Stem Cell Transplantation (HSCT). Treatment with mesenchymal stromal cells (MSC) seems to be a promising solution, however the results from clinical studies are still equivocal. Better selection of candidate patients and improving monitoring of patients following MSC administration can increase treatment effectiveness. In order to determine which characteristics can be used to predict a good response and better monitoring of patients, blood samples were taken prior to therapy, one week and one month after therapy, from 26 allogeneic HSCT patients whom contracted GvHD and were treated with MSCs. Samples were examined for differential blood counts, bilirubin levels and cell surface markers. Serum cytokine levels were also measured. We found that the level of lymphocytes, in particular T and NK cells, may predict a good response to therapy. A better response was observed among patients who expressed low levels of IL-6 and IL-22, Th17 related cytokines, prior to therapy. Patients with high levels of bilirubin prior to therapy showed a poorer response. The results of this study may facilitate early prediction of success or failure of the treatment, and subsequently, will improve selection of patients for MSC therapy.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Aplastic / immunology
  • Anemia, Aplastic / mortality
  • Anemia, Aplastic / pathology
  • Anemia, Aplastic / therapy*
  • Antineoplastic Agents / therapeutic use
  • Bilirubin
  • Biomarkers / blood
  • Female
  • Graft vs Host Disease / diagnosis*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / pathology
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / therapy*
  • Humans
  • Interleukin-22
  • Interleukin-6 / blood
  • Interleukins
  • Killer Cells, Natural / immunology
  • Killer Cells, Natural / pathology*
  • Lymphocyte Count
  • Male
  • Mesenchymal Stem Cell Transplantation*
  • Middle Aged
  • Prognosis
  • Severity of Illness Index
  • Survival Analysis
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology*
  • Thalassemia / immunology
  • Thalassemia / mortality
  • Thalassemia / pathology
  • Thalassemia / therapy*
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • Interleukins
  • Bilirubin

Grants and funding

The authors received no specific funding for this work.