Intestinal IgA positive plasma cells are highly sensitive indicators of alloreaction early after allogeneic transplantation and associate with both, graft-<i>versus-</i>host disease and relapse related mortality

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-546528 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.54652 Copy

Scheidler, Lucia ; Hippe, Katrin ; Ghimire, Sakhila ; Weber, Daniela ; Weber, Markus ; Meedt, Elisabeth ; Hoffmann, Petra ; Lehn, Petra ; Burkhardt, Ralph ; Mamilos, Andreas ; Edinger, Matthias ; Wolff, Daniel ; Poeck, Hendrik ; Evert, Matthias ; Gessner, André ; Herr, Wolfgang ; Holler, Ernst

Lizenz: Creative Commons Namensnennung-NichtKommerziell 4.0 International PDF - Veröffentlichte Version (1MB)

Veröffentlichungsdatum dieses Volltextes: 29 Aug 2023 15:04

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Details

Dokumentenart:	Artikel
Open Access Art:	Gold (mit APC - bezahlt UR)
Höhe Gebühr (aus OpenAPC):	2382.38
Institution der Zahlung:	Regensburg U
Titel eines Journals oder einer Zeitschrift:	Haematologica
Verlag:	Ferrata-Storti Foundation
Datum:	1 Juni 2023
Institutionen:	Medizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Sonstige Projekte:	Wilhelm Sander Foundation Grant 2017.020.02, Jose Carreras Leukemia foundation (grant DJCLS 01/GvHD2020), DFG – Projektnummer 324392634, SFB TR221 GvH/GvL.
Identifikationsnummer:	Wert Typ 10.3324/haematol.2022.282188 DOI
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	54652

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Zusammenfassung

Intestinal IgA is strongly involved in microbiota homeostasis. Since microbiota disruption is a major risk factor of acute GvHD, we addressed the kinetics of intestinal IgA-positive (IgA+) plasma cells by immunohistology in a series of 430 intestinal biopsies obtained at a median of 1,5 months after allogeneic stem cell transplantation from 115 patients (pts) at our center. IgA+ plasma cells were ...

Zusammenfassung

Intestinal IgA is strongly involved in microbiota homeostasis. Since microbiota disruption is a major risk factor of acute GvHD, we addressed the kinetics of intestinal IgA-positive (IgA+) plasma cells by immunohistology in a series of 430 intestinal biopsies obtained at a median of 1,5 months after allogeneic stem cell transplantation from 115 patients (pts) at our center. IgA+ plasma cells were located in the subepithelial lamina propria and suppressed in the presence of histological aGvHD (GvHD lerner stage 0: 131+/- 8 IgA+ plasma cells/mm2; stage 1-2: 108 +/-8 IgA+ plasma cells/ mm2; stage 3-4: 89+/-16 IgA+ plasma cells/ mm2, p 0.004). Overall, pts with IgA+ plasma cells below median had an increased treatment related mortality (p = 0.04). Time courses suggested a gradual recovery of IgA+ plasma cells after day 100 in the absence but not in the presence of GvHD. Vice versa IgA+ plasma cells above median early after SCT were predictive of relapse and relapse related mortality (RRM): Pts with low IgA+ cells had a 15% RRM at 2 and at 5 yrs, while pts with high IgA+ cells had a 31% RRM at 2 years and more than 46% at 5 years; multivariate analysis indicated high IgA+ plasma cells in biopsies (HR 2.7 (95% CI 1.04-7.00) as independent predictors of RRM, whereas Lerner stage and disease stage themselves did not affect RRM. In contrast, IgA serum levels at the time of biopsy were not predictive for RRM. In summary, our data indicate that IgA+ cells are highly sensitive indicators of alloreaction early after allo-SCT showing association with TRM but also allowing prediction of relapse independently from the presence of overt GvHD.

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