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

Thai M. Cao, Judith A. Shizuru, Ruby M. Wong, Kevin Sheehan, Ginna G. Laport, Keith E. Stockerl-Goldstein, Laura J. Johnston, Monic J. Stuart, F. Carl Grumet, Robert S. Negrin, Robert Lowsky

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

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 nonmyeloablative 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.

Original languageEnglish
Pages (from-to)2300-2306
Number of pages7
JournalBlood
Volume105
Issue number6
DOIs
StatePublished - Mar 15 2005

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