TY - JOUR
T1 - Bone marrow haploidentical transplant with post-transplantation cyclophosphamide
T2 - does graft cell content have an impact on main clinical outcomes?
AU - Teofili, Luciana
AU - Chiusolo, Patrizia
AU - Valentini, Caterina Giovanna
AU - Metafuni, Elisabetta
AU - Bellesi, Silvia
AU - Orlando, Nicoletta
AU - Bianchi, Maria
AU - Giammarco, Sabrina
AU - Sica, Simona
AU - Bacigalupo, Andrea
N1 - Funding Information:
LT handled conception and design of the study, acquisition of data, analysis and interpretation of data, article writing and final approval of the submitted version. PC, CGV and EM handled interpretation of data and article writing. SB, NO, MB and SG did acquisition of data and analysis. SS and AB did the critical revision for important intellectual content.
Publisher Copyright:
© 2020 International Society for Cell and Gene Therapy
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/3
Y1 - 2020/3
N2 - We analyzed data relative to cell content in 88 consecutive patients receiving HLA haploidentical bone marrow (BM) transplants with post-transplantation cyclophosphamide (PT-CY). Median age was 54.5 (range, 17–72); diagnoses were acute leukemia (n = 46), lymphoproliferative disorders (n = 24), myelofibrosis (n = 11) and myelodysplastic syndromes (n = 5). Total nucleated cell (TNC) and CD34+, CD3+, CD4+ and CD8+ cell doses were stratified as higher than first, second and third quartile and the dose effect on various clinical outcomes was assessed. Median time to engraftment was 17 days for neutrophils and 24 days for platelets. To receive a dose of TNC ≥3.2 x 106/kg or CD34+ cells ≥2.7 x 106/kg significantly shortened the time to neutrophil and platelet engraftment and reduced the blood product requirements in the 30-day period after transplantation. Overall, TNC and CD34+ cell doses had no effect on acute graft-versus-host disease (GVHD) incidence, whereas patients receiving higher CD3+ and CD8+ cell doses seemed to have less chronic GVHD. No effect on non-relapse mortality, progression-free survival and overall survival was observed at different cell dose thresholds. These data suggest that in HLA haploidentical BM transplant with PT-CY, appropriate cell doses are relevant to the engraftment. The association between low CD3+/CD8+ cells and chronic GVHD deserves further investigation.
AB - We analyzed data relative to cell content in 88 consecutive patients receiving HLA haploidentical bone marrow (BM) transplants with post-transplantation cyclophosphamide (PT-CY). Median age was 54.5 (range, 17–72); diagnoses were acute leukemia (n = 46), lymphoproliferative disorders (n = 24), myelofibrosis (n = 11) and myelodysplastic syndromes (n = 5). Total nucleated cell (TNC) and CD34+, CD3+, CD4+ and CD8+ cell doses were stratified as higher than first, second and third quartile and the dose effect on various clinical outcomes was assessed. Median time to engraftment was 17 days for neutrophils and 24 days for platelets. To receive a dose of TNC ≥3.2 x 106/kg or CD34+ cells ≥2.7 x 106/kg significantly shortened the time to neutrophil and platelet engraftment and reduced the blood product requirements in the 30-day period after transplantation. Overall, TNC and CD34+ cell doses had no effect on acute graft-versus-host disease (GVHD) incidence, whereas patients receiving higher CD3+ and CD8+ cell doses seemed to have less chronic GVHD. No effect on non-relapse mortality, progression-free survival and overall survival was observed at different cell dose thresholds. These data suggest that in HLA haploidentical BM transplant with PT-CY, appropriate cell doses are relevant to the engraftment. The association between low CD3+/CD8+ cells and chronic GVHD deserves further investigation.
KW - bone marrow
KW - cyclophosphamide
KW - engraftment
KW - graft-versus-host disease
KW - haploidentical transplant
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U2 - 10.1016/j.jcyt.2020.01.007
DO - 10.1016/j.jcyt.2020.01.007
M3 - Article
C2 - 32057614
AN - SCOPUS:85079158338
VL - 22
SP - 158
EP - 165
JO - Cytotherapy
JF - Cytotherapy
SN - 1465-3249
IS - 3
ER -