CD3+ graft cell count influence on chronic GVHD in haploidentical allogeneic transplantation using post-transplant cyclophosphamide

A Mussetti, C De Philippis, C Carniti, M Bastos-Oreiro, J Gayoso, N Cieri, M Pennisi, F Ciceri, R Greco, J Peccatori, F Patriarca, J Mariotti, L Castagna, P Corradini

Research output: Contribution to journalArticle

Abstract

The effects of graft or donor characteristics in haploidentical hematopoietic cell transplantation (HCT) using post-transplant cyclophosphamide (PT-Cy) are largely unknown. In this multicenter retrospective study we analyzed the correlations between graft cell composition (CD34+, CD3+) and donor features on transplant outcomes in 234 patients who underwent HCT between 2010 and 2016. On multivariate analysis, the use of peripheral blood stem cells (PBSC) was associated with an increased incidence of grade 2-4 acute GVHD [HR 1.94, 95% confidence Interval (CI) = 1.01-3.98, p = 0.05]. An elevated CD3+ graft content was associated with an increased incidence of all-grade chronic GVHD [HR 1.36 (95% CI = 1.06-1.74), p = 0.01]. This effect was confirmed only for the PBSC graft group. A higher CD34+ graft content had a protective role on non-relapse mortality [HR 0.78 (95% CI = 0.62-0.96), p = 0.02] but this was confirmed only for the bone marrow (BM)-derived graft cohort. Donor characteristics did not influence any outcomes. GVHD prophylaxis should be modulated accordingly to CD3+ graft content, especially when a PBSC graft is used. These results need further validation in prospective trials.

Original languageEnglish
Pages (from-to)1522-1531
Number of pages10
JournalBone Marrow Transplantation
Volume53
Issue number12
DOIs
Publication statusPublished - Dec 2018

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Homologous Transplantation
Cyclophosphamide
Cell Count
Transplants
Cell Transplantation
Tissue Donors
Confidence Intervals
Incidence
Multicenter Studies
Multivariate Analysis
Retrospective Studies
Bone Marrow
Mortality

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CD3+ graft cell count influence on chronic GVHD in haploidentical allogeneic transplantation using post-transplant cyclophosphamide. / Mussetti, A; De Philippis, C; Carniti, C; Bastos-Oreiro, M; Gayoso, J; Cieri, N; Pennisi, M; Ciceri, F; Greco, R; Peccatori, J; Patriarca, F; Mariotti, J; Castagna, L; Corradini, P.

In: Bone Marrow Transplantation, Vol. 53, No. 12, 12.2018, p. 1522-1531.

Research output: Contribution to journalArticle

Mussetti, A ; De Philippis, C ; Carniti, C ; Bastos-Oreiro, M ; Gayoso, J ; Cieri, N ; Pennisi, M ; Ciceri, F ; Greco, R ; Peccatori, J ; Patriarca, F ; Mariotti, J ; Castagna, L ; Corradini, P. / CD3+ graft cell count influence on chronic GVHD in haploidentical allogeneic transplantation using post-transplant cyclophosphamide. In: Bone Marrow Transplantation. 2018 ; Vol. 53, No. 12. pp. 1522-1531.
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abstract = "The effects of graft or donor characteristics in haploidentical hematopoietic cell transplantation (HCT) using post-transplant cyclophosphamide (PT-Cy) are largely unknown. In this multicenter retrospective study we analyzed the correlations between graft cell composition (CD34+, CD3+) and donor features on transplant outcomes in 234 patients who underwent HCT between 2010 and 2016. On multivariate analysis, the use of peripheral blood stem cells (PBSC) was associated with an increased incidence of grade 2-4 acute GVHD [HR 1.94, 95{\%} confidence Interval (CI) = 1.01-3.98, p = 0.05]. An elevated CD3+ graft content was associated with an increased incidence of all-grade chronic GVHD [HR 1.36 (95{\%} CI = 1.06-1.74), p = 0.01]. This effect was confirmed only for the PBSC graft group. A higher CD34+ graft content had a protective role on non-relapse mortality [HR 0.78 (95{\%} CI = 0.62-0.96), p = 0.02] but this was confirmed only for the bone marrow (BM)-derived graft cohort. Donor characteristics did not influence any outcomes. GVHD prophylaxis should be modulated accordingly to CD3+ graft content, especially when a PBSC graft is used. These results need further validation in prospective trials.",
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AU - De Philippis, C

AU - Carniti, C

AU - Bastos-Oreiro, M

AU - Gayoso, J

AU - Cieri, N

AU - Pennisi, M

AU - Ciceri, F

AU - Greco, R

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AU - Mariotti, J

AU - Castagna, L

AU - Corradini, P

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AB - The effects of graft or donor characteristics in haploidentical hematopoietic cell transplantation (HCT) using post-transplant cyclophosphamide (PT-Cy) are largely unknown. In this multicenter retrospective study we analyzed the correlations between graft cell composition (CD34+, CD3+) and donor features on transplant outcomes in 234 patients who underwent HCT between 2010 and 2016. On multivariate analysis, the use of peripheral blood stem cells (PBSC) was associated with an increased incidence of grade 2-4 acute GVHD [HR 1.94, 95% confidence Interval (CI) = 1.01-3.98, p = 0.05]. An elevated CD3+ graft content was associated with an increased incidence of all-grade chronic GVHD [HR 1.36 (95% CI = 1.06-1.74), p = 0.01]. This effect was confirmed only for the PBSC graft group. A higher CD34+ graft content had a protective role on non-relapse mortality [HR 0.78 (95% CI = 0.62-0.96), p = 0.02] but this was confirmed only for the bone marrow (BM)-derived graft cohort. Donor characteristics did not influence any outcomes. GVHD prophylaxis should be modulated accordingly to CD3+ graft content, especially when a PBSC graft is used. These results need further validation in prospective trials.

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