Higher proportions of peripheral CD19+CD5+ B cells predict the effect of corticosteroid in patients with late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation.

Abstract

BACKGROUND:

The cause of late-onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains obscure. In clinical practice, some LOHC patients respond to immunosuppression. The aim of this study was to determine the immune pathogenesis of LOHC post allo-HSCT.

METHODS:

With the diagnosis of LOHC, patients were given initial treatment consisting of fluid hydration, alkalization and forced diuresis, and empirical anti-viral therapy for 10 - 14 days or until a week after the virus became negative. The nonresponders were applied corticosteroid. Seven to ten days later, patients' response was evaluated. Along with treatment, CD19(+) B lymphocyte subsets were measured at various study points.

RESULTS:

From October 2009 to March 2010, we found 28 cases of LOHC occurred in 25 patients who underwent allo-HSCT in our hospital. Except that three cases were not treated according to the protocol, the other 25 cases were divided into three groups: anti-virus responders (Group A, n = 6), corticosteroid responders (Group B1, n = 16), corticosteroid and anti-virus nonresponders (Group C, n = 3) according to their clinical response. Percentages of CD19(+)CD5(+) B lymphocytes were not significantly different among three groups at onset of LOCH. However, in Group B1 after the first anti-virus phase, percentages of CD19(+)CD5(+) lymphocytes significantly increased comparing with those at onset (P = 0.022), and then significantly decreased at PR (P = 0.003) and CR (P = 0.002) with corticosteroid treatment. But significant change was not observed in Groups A and C.

CONCLUSION:

The immune etiology seems to be involved in the development of LOHC and the proportion of CD19(+)CD5(+) lymphocytes may serve as a cellular biomarker to predict the response to corticosteroid in LOHC.

• Authors: Hai-Xia Fu, Lan-Ping Xu, Dai-Hong Liu, Kai-Yan Liu, Huan Chen, Wei Han, Xiao-Hui Zhang, Yu Wang, Feng-Rong Wang, Jing-Zhi Wang, Ting Zhao, Yuan-Yuan Zhang, Yao Chen, Xiao-Jun Huang
• Journal: Chinese medical journal (Chin Med J (Engl)) Vol. 124 Issue 10 Pg. 1517-23 (May 2011) ISSN: 2542-5641 [Electronic] China
• PMID: 21740809 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenal Cortex Hormones
• Antigens, CD19
• CD5 Antigens

Topics

• Adolescent
• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Antigens, CD19 (metabolism)
• B-Lymphocytes (metabolism)
• CD5 Antigens (metabolism)
• Child
• Child, Preschool
• Cystitis (drug therapy, immunology, therapy)
• Female
• Flow Cytometry
• Hematopoietic Stem Cell Transplantation
• Humans
• Male
• Middle Aged
• Young Adult