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. 2018 Nov 29;16(4):eAO4278.
doi: 10.31744/einstein_journal/2018AO4278.

Polyclonal anti T-lymphocyte antibody therapy monitoring in kidney transplant recipients: comparison of CD3+ T cell and total lymphocyte counts

[Article in English, Portuguese]
Fabiani Palagi Machado  1   2 , Alessandra Rosa Vicari  2 , Fábio Spuldaro  2 , João Batista Saldanha de Castro Filho  1   2 , Roberto Ceratti Manfro  1   2
Affiliations

Polyclonal anti T-lymphocyte antibody therapy monitoring in kidney transplant recipients: comparison of CD3+ T cell and total lymphocyte counts

[Article in English, Portuguese]
Fabiani Palagi Machado et al. Einstein (Sao Paulo). .

Abstract
in English, Portuguese

Objective: To investigate the correlation between total lymphocyte and CD3+ T cell counts in peripheral blood in renal transplant patients treated with anti-thymocyte globulin, and discuss related outcomes.

Methods: A single-center, retrospective study involving 226 patients submitted to kidney transplant between 2008 and 2013, and treated with anti-thymocyte globulin for induction or treatment of cellular rejection. Doses were adjusted according to CD3+ T cell or total lymphocyte counts in peripheral blood.

Results: A total of 664 paired samples were analyzed. The Spearman's correlation coefficient was 0.416 (p<0.001) for all samples combined; the overall Kappa coefficient was 0.267 (p<0.001). Diagnostic parameters estimated based on total lymphocyte counts were also calculated using the number of CD3+ T cells (gold standard), with a cut off of >20 cells/mm3.

Conclusion: Total lymphocyte and CD3+ T cell counts in peripheral blood are not equivalent monitoring strategies in anti-thymocyte globulin therapy.

Objetivo:: Investigar a correlação entre a contagem de linfócitos totais e células T CD3+ no sangue periférico em receptores de transplante renal submetidos a tratamento com globulina antitimocitária, e discutir resultados relacionados.

Métodos:: Estudo retrospectivo de centro único envolvendo 226 pacientes submetidos a transplante renal entre 2008 e 2013 e tratados com globulina antitimocitária, para fins de indução ou tratamento de rejeição celular. As doses foram ajustadas de acordo com a contagem de células T CD3+ ou linfócitos totais no sangue periférico.

Resultados:: No total, 664 amostras pareadas foram analisadas. O coeficiente de correlação de Spearman para as amostras em geral foi de 0,416 (p<0,001) e o coeficiente Kappa, de 0,267 (p<0,001). Os parâmetros diagnósticos estimados com base na contagem de linfócitos totais foram recalculados, empregando-se o número de células T CD3+ (padrão-ouro) e adotando-se o ponto de corte >20 células/mm3.

Conclusão:: A contagem de linfócitos totais no sangue periférico não substitui a contagem de células T CD3+ enquanto estratégia de monitorização da terapia à base de globulina antitimocitária.

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Conflict of interest statement

Conflict of interest:

none.

Figures

Figure 1
Figure 1. Correlation between CD3+ T cells and total lymphocyte cell counts
Figure 2
Figure 2. Estimated (Kaplan-Meier) overall patient and graft survival
P: patient; G: graft.
Figure 3
Figure 3. Estimated (Kaplan-Meier) patient survival according to anti-thymocyte globulin indication
P: prophylactic; T: therapeutic.
Figure 4
Figure 4. Estimated (Kaplan-Meier) graft survival according to anti-thymocyte globulin indication
P: prophylactic; T: therapeutic.
See this image and copyright information in PMC

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