Influence of bone marrow graft lymphocyte subsets on outcome after HLA-identical sibling transplants

• Published in: Experimental hematology 2001-11, Vol.29 (11), p.1347-1352
• Main Authors: Rocha, Vanderson, Carmagnat, Marie-Vonique, Chevret, Sylvie, Flinois, Odile, Bittencourt, Henrique, Esperou, Hélène, Garnier, Federico, Ribaud, Patricia, Devergie, Agnès, Socié, Gérard, Dal'Cortivo, Liliane, Marolleau, Jean-Pierre, Charron, Dominique, Gluckman, Eliane, Rabian, Claire
• Format: Article
• Language: English
• Subjects: Acute Disease; Adolescent; Adult; Antigens, CD34 - analysis; Bone Marrow Transplantation - mortality; CD3 Complex - analysis; CD4-Positive T-Lymphocytes - transplantation; CD8-Positive T-Lymphocytes - transplantation; Child; Child, Preschool; Chronic Disease; Comorbidity; Cytomegalovirus Infections - epidemiology; Female; France - epidemiology; Graft Survival; Graft vs Host Disease - epidemiology; Graft vs Host Disease - immunology; Graft vs Host Disease - prevention & control; Hematologic Neoplasms - mortality; Hematologic Neoplasms - therapy; Histocompatibility; Humans; Incidence; Leukocyte Count; Lymphocyte Count; Lymphocyte Subsets - transplantation; Male; Middle Aged; Neutrophils; Nuclear Family; Risk; Survival Analysis; Tissue Donors; Transplantation, Homologous
• ISSN: 0301-472X; 1873-2399
• DOI: 10.1016/S0301-472X(01)00737-8

The aim of this study was to analyze bone marrow lymphocyte subsets and CD34 cell dose and their influence on the outcomes of bone marrow transplantation. Forty-eight patients (median age 30 years, range 5–54) receiving HLA-identical sibling bone marrow transplantation for hematologic malignancies were analyzed. Median number (range) of nucleated cells and CD34 + cells infused were 2.4 (0.4–6.0) × 10 8/kg and 3.5 (0.5–13.0) × 10 6/kg, respectively. Probability of neutrophil recovery was 97%. In a multivariate analysis, time to neutrophil recovery was shortened when a higher number of CD3/CD8 cells was infused (≥1.0 × 10 7/kg) ( hazard ratio [ HR] = 2.13, p = 0.018) ; when the patient was female or had negative cytomegalovirus serology ( HR = 2.03, p = 0.03; HR = 0.41, p = 0.009; respectively) . The incidence of grade II to IV acute graft-vs-host disease (GVHD) was 47%. Infusion of >1 × 10 7 CD4 infused/kg increased the risk of acute GVHD ( HR = 2.86, p = 0.03) . Nineteen of 40 patients at risk experienced chronic GVHD, the risk of which was increased by diagnosis of chronic leukemia ( p = 0.03) ,