Engraftment and survival following reduced-intensity allogeneic peripheral blood hematopoietic cell transplantation is affected by CD8+ T-cell dose

Blood. 2005 Mar 15;105(6):2300-6. doi: 10.1182/blood-2004-04-1473. Epub 2004 Nov 30.

Abstract

The influence of graft composition on clinical outcomes after reduced-intensity conditioning is not well-characterized. In this report we prospectively enumerated CD34+, CD3+, CD4+, and CD8+ cell doses in granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cell (G-PBMC) allografts in 63 patients who received transplants following non-myeloablative conditioning with total body irradiation 200 cGy plus fludarabine as treatment for malignant diseases. Donors were HLA-identical siblings (n = 38) or HLA-matched unrelated individuals (n = 25). By univariate analyses G-PBMC CD8+ T-cell dose in at least the 50th percentile favorably correlated with full donor blood T-cell chimerism (P = .03), freedom from progression (P = .001), and overall survival (P = .01). No G-PBMC cell dose influenced grade II to IV acute or extensive chronic graft-versus-host disease. In multivariate analysis only G-PBMC CD8+ T-cell dose (P = .003; RR = 0.2, 95% CI = 0.1-0.6) was associated with improved freedom from progression. Infusion of low G-PBMC CD8+ T-cell dose for reduced-intensity allografting may adversely affect T-cell engraftment and survival outcome.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Antigens, CD
  • CD8-Positive T-Lymphocytes / transplantation*
  • Chronic Disease
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Graft Survival* / radiation effects
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / mortality
  • Granulocyte-Macrophage Colony-Stimulating Factor / administration & dosage
  • Hematologic Neoplasms / mortality*
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Mobilization
  • Histocompatibility Testing
  • Humans
  • Male
  • Middle Aged
  • Myeloablative Agonists
  • Peripheral Blood Stem Cell Transplantation / mortality*
  • Recombinant Proteins
  • Survival Rate
  • Transplantation Chimera
  • Transplantation Conditioning* / mortality
  • Transplantation, Homologous
  • Treatment Outcome
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives
  • Whole-Body Irradiation

Substances

  • Antigens, CD
  • Myeloablative Agonists
  • Recombinant Proteins
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Vidarabine
  • fludarabine