477 Immune Reconstitution Analysis of Patients Undergoing Extracorporeal Photopheresis for the Treatment of Chronic Graft-Versus-Host Disease

Track: Poster Abstracts
Saturday, February 14, 2015, 6:45 PM-7:45 PM
Grand Hall CD (Manchester Grand Hyatt)
Stacey Fanning, Ph.D. , Touro College of Osteopathic Medicine, New York, NY
Kristin Vazzana, B.S. , John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
Michele L. Donato, MD , John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
Robert Korngold, PhD , John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
Presentation recording not available for download or distribution as requested by the presenting author.
Allogeneic blood and marrow transplantation for the treatment of hematologic malignancies continues to be plagued by complications such as chronic graft-versus-host disease (cGVHD), which can occur in upwards of 50% of patients. Standard therapy involves corticosteroid administration, which is not always effective and impedes the patient’s return to a completely competent immune system, thus increasing the risk of infectious complications. Extracorporeal photopheresis (ECP) has been successfully used to abate cGVHD symptoms in many patients. The effect this therapy has on lymphocyte subsets in the reconstituting immune compartment has yet to be fully ascertained. In the present study, we used flow cytometric analysis to examine lymphocyte subsets in patients undergoing ECP for the treatment of cGVHD. Peripheral blood was collected from 5 patients prior to starting ECP and after 90 days of treatment. CD4+ T cell populations were analyzed for expression of CD45RA and CCR7 to classify naïve (RA+, CCR7+), central memory (TCM; RA-, CCR7+), effector memory (TEM; RA-, CCR7-), and terminally differentiated effector memory (TEMRA; RA+, CCR7-) T cells. The data reported supports previous studies which show that all CD4+ T cell populations analyzed are altered in cGVHD patients (n=11) compared to healthy controls (n=5). In particular, CD4+ TCM and naïve cells were decreased in cGVHD patients, while CD4+ TEM and TEMRA were elevated in these patients. Analysis of the same subsets in cGVHD patients after 90 days of ECP treatment revealed that the percentage of CD4+ TCM increased above baseline levels in the 5 cGVHD patients examined, while CD4+ TEMRA were decreased during the same time frame. The increase in CD4+ TCM and the decrease in CD4+ TEMRA were statistically significant as determined by the paired Student’s t test. Additionally, the ratio of CD4+ TCM to TEM and CD4+ TCM to TEMRA was calculated in patients before and after ECP treatment. Results indicate significantly increased ratios of both TCM:TEM and CD4+ TCM:TEMRA in these patients as well. This data strongly supports the role of ECP in the normalization of CD4+ T cell populations in cGVHD patients.
Disclosures:
Nothing To Disclose
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