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Receiver operating characteristic curve analysis of circulating blood dendritic cell precursors and T cells predicts response to extracorporeal photopheresis in patients with chronic graft‐versus‐host disease
Author(s) -
Akhtari Mojtaba,
Giver Cynthia R.,
Ali Zahir,
Flowers Christopher R.,
Gleason Charise L.,
Hillyer Christopher D.,
Kaufman Jonathan,
Khoury H. Jean,
Langston Amelia A.,
Lechowicz Mary Jo,
Lonial Sagar,
Renfroe Heather M.,
Roback John D.,
Tighiouart Mourad,
Vaughn Louette,
Waller Edmund K.
Publication year - 2010
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2010.02712.x
Subject(s) - extracorporeal photopheresis , photopheresis , medicine , cd8 , immunology , leukapheresis , dendritic cell , t cell , graft versus host disease , receiver operating characteristic , immune system , gastroenterology , disease , lymphoma , stem cell , biology , cd34 , genetics
BACKGROUND: One proposed mechanism of extracorporeal photopheresis (ECP) in reducing chronic graft‐versus‐host disease (cGVHD) is alteration in numbers of circulating dendritic cells (DCs). This hypothesis was tested by correlating numbers of DC precursors and T cells in the blood before and during ECP therapy with response of cGVHD. STUDY DESIGN AND METHODS: Twenty‐five patients with cGVHD were treated with ECP. Data were collected with emphasis on blood cellular markers, clinical response to ECP, and overall survival. RESULTS: Fourteen patients (56%) responded and had better 2‐year survival than nonresponders (88% vs. 18%, p = 0.003). Responders had higher baseline circulating myeloid DC (mDC) and plasmacytoid DC precursors and CD4+ and CD8+ T cells compared with nonresponders. Receiver operating characteristic curve analyses showed that the best baseline cutoff values to predict response to ECP were mDC counts of 3.7 cells/µL (79% sensitivity, 82% specificity) and CD4+ T‐cell counts of 104 cells/µL (71% sensitivity, 82% specificity). CD4+ T cells declined in responders over time, but not in nonresponders, and no significant changes were seen in CD8 T‐cell or DC numbers over a 12‐month period in responder or nonresponder groups. CONCLUSIONS: Higher baseline numbers of circulating DCs and T cells may predict clinical response to ECP in patients with cGVHD.