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Author Notes:

Edmund K. Waller, MD, PhD, Winship Cancer Institute, 1365-C Clifton Road, 4th Floor, Suite C4002, Atlanta, GA 30322; ewaller@emory.edu

The first two authors contributed equally to this work.

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Research Funding:

CRG was supported in part by NIH Grant T32 HL069769.

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

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Journal Title:

Transfusion

Volume:

Volume 50, Number 11

Publisher:

, Pages 2424-2431

Type of Work:

Article | Post-print: After Peer Review

Abstract:

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.

Copyright information:

© 2010 American Association of Blood Banks

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