Recent thymic emigrants in lymphoma patients with and without human immunodeficiency virus infection candidates for autologous peripheral stem cell transplantation

Clin Exp Immunol. 2008 Jan;151(1):101-9. doi: 10.1111/j.1365-2249.2007.03516.x. Epub 2007 Oct 11.

Abstract

Signal joint T cell receptor excision circles (sjTRECs) have been reported as a clinical marker to measure the potential for recovery of the immune system after immunosuppressive treatments. The aim of this study was to investigate the thymic regenerative potential in 55 human immunodeficiency virus (HIV)-1 infected (HIV(+)) and non-infected (HIV(-)) lymphoma patients, candidates for autologous stem cell transplantation (ASCT). Moreover, the possible associations between sjTRECs and other immunological and clinical parameters were examined. SjTRECs levels in peripheral blood mononuclear cells (PBMCs) were quantified by real-time polymerase chain reaction and T lymphocyte subsets were analysed by flow cytometry. Our data showed that sjTRECs were reduced in lymphoma patients compared to healthy controls, although a weak significant association between low sjTRECs levels and increasing age was maintained [odds ratio (OR) = 4.00; 95% confidence interval (CI) 1.09-17.17]. We found that different chemotherapeutic treatments seem to induce similar effects on the thymic reservoir, independently from their intensity (type and number of cycles of previous chemotherapy). Results from multivariate models including adjustment for patients' sex, type of lymphoma and type of chemotherapy showed that thymic output was independent from HIV infection (OR, 0.95; 95% CI 0.20-4.48). SjTRECs levels correlated with naive T cell subsets in overall lymphoma patients and after stratification by HIV infection (r > 0.37). HIV replication should be maximally suppressed to properly evaluate thymic output by sjTREC markers. Our results suggested that de novo T cell generation is maintained partially in pretreated recurrent lymphoma patients, candidates for ASCT, and could contribute to restore the immune function after transplantation.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anti-HIV Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • CD4-CD8 Ratio
  • Case-Control Studies
  • Cyclophosphamide / therapeutic use
  • DNA Repair / genetics*
  • DNA, Circular*
  • Doxorubicin / therapeutic use
  • Female
  • Flow Cytometry
  • Gene Rearrangement, T-Lymphocyte / genetics
  • Genetic Markers
  • HIV Infections / drug therapy
  • HIV Infections / immunology*
  • HIV Infections / therapy
  • HIV-1*
  • Humans
  • Lymphoma, AIDS-Related / drug therapy
  • Lymphoma, AIDS-Related / immunology*
  • Lymphoma, AIDS-Related / therapy
  • Male
  • Middle Aged
  • Odds Ratio
  • Peripheral Blood Stem Cell Transplantation
  • Prednisone / therapeutic use
  • Prognosis
  • Reverse Transcriptase Polymerase Chain Reaction
  • Risk Factors
  • T-Lymphocytes / immunology*
  • Transplantation, Autologous
  • Vincristine / therapeutic use
  • Virus Replication

Substances

  • Anti-HIV Agents
  • DNA, Circular
  • Genetic Markers
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol