An early increase of CD56bright natural killer subset as dominant effect and predictor of response to extracorporeal photopheresis for graft‐versus‐host disease. Issue 12 (27th September 2018)

• Record Type: Journal Article
• Authors: Iniesta, Pastora; Revilla, Nuria; Chen‐Liang, Tzu Hua; Hurtado, Ana María; Vicente, Vicente; Heras, Inmaculada; Jerez, Andrés; Lozano, María Luisa
• Is Part Of: Transfusion. Volume 58:Issue 12(2018)
• Page Start: 2924
• Page End: 2932
• Publication Date: 2018-09-27
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.14964
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract : BACKGROUND: CD56 bright natural killer (NK) regulatory cells were recently shown to display a differential impact on the risk of developing extensive chronic graft‐versus‐host disease (GVHD). To date no study has definitively established which immune populations are most responsible for the immunomodulatory effects or response to extracorporeal photopheresis (ECP) for GVHD. STUDY DESIGN AND METHODS: To test the role of CD56 bright NK cells in ECP, a prospective enhanced flow cytometry follow‐up of immune subsets (CD19+, CD3+, CD3+/CD4+, CD3+/CD8+, CD3‐/CD56+, CD3‐/CD56 bright, and CD3‐/CD56 dim ) was performed in 32 patients with GVHD who underwent 552 procedures. RESULTS: An early increase of CD56 bright NK cells was found as a hallmark effect to ECP, particularly during the first 3 months of treatment. This was also supported by the ability to predict for complete responses when this increase was expressed as a higher CD56 bright versus CD56 dim NK cells ratio. Among the immune subsets tested, the only variable that had direct influence on response to ECP was a CD56 bright/dim ratio more than 0.16 (hazard ratio [HR] 4.32, p = 0.014; HR 5.8, p = 0.007, at 2 and 3 months of ECP treatment, respectively). CONCLUSION: These findings argue for exploring strategies for priming a CD56 bright NK cell expansion during ECP and providing additional and potentially relevant data for revisiting the underpinning cellular mechanisms of ECP that could generate that expansion.