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

Mojtaba Akhtari, Cynthia R. Giver, Zahir Ali, Christopher R. Flowers, Charise L. Gleason, Christopher D. Hillyer, Jonathan Kaufman, H. Jean Khoury, Amelia A. Langston, Mary Jo Lechowicz, Sagar Lonial, Heather M. Renfroe, John D. Roback, Mourad Tighiouart, Louette Vaughn, Edmund K. Waller

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)2424-2431
Number of pages8
JournalTransfusion
Volume50
Issue number11
DOIs
StatePublished - Nov 1 2010

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Photopheresis
T-Lymphoid Precursor Cells
Graft vs Host Disease
ROC Curve
Dendritic Cells
Blood Cells
T-Lymphocytes
Cell Count
Sensitivity and Specificity
Survival
Myeloid Cells
CD4 Lymphocyte Count
Biomarkers

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

Cite this

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. / Akhtari, Mojtaba; Giver, Cynthia R.; Ali, Zahir; Flowers, Christopher R.; Gleason, Charise L.; Hillyer, Christopher D.; Kaufman, Jonathan; Khoury, H. Jean; Langston, Amelia A.; Lechowicz, Mary Jo; Lonial, Sagar; Renfroe, Heather M.; Roback, John D.; Tighiouart, Mourad; Vaughn, Louette; Waller, Edmund K.

In: Transfusion, Vol. 50, No. 11, 01.11.2010, p. 2424-2431.

Research output: Contribution to journalArticle

Akhtari, M, Giver, CR, Ali, Z, Flowers, CR, Gleason, CL, Hillyer, CD, Kaufman, J, Khoury, HJ, Langston, AA, Lechowicz, MJ, Lonial, S, Renfroe, HM, Roback, JD, Tighiouart, M, Vaughn, L & Waller, EK 2010, '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', Transfusion, vol. 50, no. 11, pp. 2424-2431. https://doi.org/10.1111/j.1537-2995.2010.02712.x
Akhtari, Mojtaba ; Giver, Cynthia R. ; Ali, Zahir ; Flowers, Christopher R. ; Gleason, Charise L. ; Hillyer, Christopher D. ; Kaufman, Jonathan ; Khoury, H. Jean ; Langston, Amelia A. ; Lechowicz, Mary Jo ; Lonial, Sagar ; Renfroe, Heather M. ; Roback, John D. ; Tighiouart, Mourad ; Vaughn, Louette ; Waller, Edmund K. / 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. In: Transfusion. 2010 ; Vol. 50, No. 11. pp. 2424-2431.
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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.",
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T1 - 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

AU - Akhtari, Mojtaba

AU - Giver, Cynthia R.

AU - Ali, Zahir

AU - Flowers, Christopher R.

AU - Gleason, Charise L.

AU - Hillyer, Christopher D.

AU - Kaufman, Jonathan

AU - Khoury, H. Jean

AU - Langston, Amelia A.

AU - Lechowicz, Mary Jo

AU - Lonial, Sagar

AU - Renfroe, Heather M.

AU - Roback, John D.

AU - Tighiouart, Mourad

AU - Vaughn, Louette

AU - Waller, Edmund K.

PY - 2010/11/1

Y1 - 2010/11/1

N2 - 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.

AB - 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.

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