학술논문
Absence of influence of peripheral blood CD34+ and CD3+ graft cell counts on outcomes after reduced-intensity conditioning transplantation using post-transplant cyclophosphamide.
Document Type
Journal Article
Author
Garnier, Alice; Guillaume, Thierry; Peterlin, Pierre; Le Bourgeois, Amandine; Mahé, Béatrice; Dubruille, Viviane; Blin, Nicolas; Touzeau, Cyrille; Gastinne, Thomas; Lok, Anne; Tessoulin, Benoit; Duquesne, Alix; Eveillard, Marion; Le Gouill, Steven; Moreau, Philippe; Béné, Marie C.; Chevallier, Patrice
Source
Subject
*BLOOD cells
*STEM cells
*TRANSPLANTATION of organs, tissues, etc.
*BLOOD
*STEM cell transplantation
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Language
ISSN
0939-5555
Abstract
The influence of peripheral blood stem cell (PBSC) graft cell contents after transplant with post-transplant cyclophosphamide (PTCY) remains unclear. Here, we retrospectively report on a cohort of 77 adults who received a Baltimore-based reduced-intensity conditioning regimen either with fludarabine (n = 40) or clofarabine (n = 37) and PTCY. With a median follow-up of 29.2 months, [2-]year overall (OS), disease-free (DFS), and GVHD/relapse-free survival (GRFS) rates were 62.8%, 51%, and 36.7%, respectively. The incidence of grades [2-]4 acute GVHD was significantly higher in patients transplanted with a haplodonor (n = 56), at 57.1% vs 19% (p = 0.006). PBSC graft cell contents (CD45+, CD34+, and CD3+ cells) had no impact on any outcome. Considering immune reconstitution until 1 year, only monocytes were above the normal range (as early as day + 30) during the first year post-transplant. In multivariate analysis, an older donor (> 45 years) and a high/very high disease risk index were independently associated with lower OS. A higher monocyte count (> median) at day + 90 was also associated with better OS, DFS, and GRFS. Donor/recipient CMV status matching was independently associated with GRFS. In conclusion, our data support the fact that there is no need to manipulate the graft before infusion in the particular context of PBSC/PTCY Baltimore-based allotransplant. [ABSTRACT FROM AUTHOR]