Influence of transplanted dose of CD56+ cells on development of graft-versus-host disease in patients receiving G-CSF-mobilized peripheral blood progenitor cells from HLA-identical sibling donors.
We investigated effects of variations in the cellular composition of G-CSF-mobilized peripheral blood progenitor cell (G-PBPC) allografts on clinical outcomes of allogeneic PBPC transplantation. We retrospectively analyzed transplanted doses of various immunocompetent cells from 27 HLA-identical sibling donors in relation to engraftment, incidence of graft-versus-host disease (GVHD), and survival. Significant variability was documented in both absolute numbers and relative proportions of CD34+, CD2+, CD3+, CD4(high)+, CD4+25+, CD8(high)+, CD19+, CD56+, and CD56+16+ cells contained in these allografts. Stepwise Cox regression analysis revealed that the CD56+ cell dose was significantly inversely correlated with the incidence of GVHD. Thus, there was a significantly higher incidence of grade II acute GVHD in patients receiving a lower CD56+16+ cell dose (hazard ratio (HR) 0.0090; 95% confidence interval (CI), <0.00001-3.38; P=0.031), a higher incidence of chronic GVHD in those receiving allografts with a lower CD56+16+ to CD34+ ratio (HR <0.00001; 95% CI <0.00001-0.0007; P=0.0035), and a higher incidence of extensive chronic GVHD in those receiving allografts with a lower CD56+ to CD34+ ratio (HR <0.00001; 95% CI <0.00001-0.053; P=0.0083). These results suggest that CD56+ cells in G-PBPC allografts from HLA-identical sibling donors may play an important role in preventing the development of GVHD.
Yamasaki
S
S
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Henzan
H
H
Ohno
Y
Y
Yamanaka
T
T
Iino
T
T
Itou
Y
Y
Kuroiwa
M
M
Maeda
M
M
Kawano
N
N
Kinukawa
N
N
Miyamoto
T
T
Nagafuji
K
K
Shimoda
K
K
Inaba
S
S
Hayashi
S
S
Taniguchi
S
S
Shibuya
T
T
Gondo
H
H
Otsuka
T
T
Harada
M
M
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis* / Q000276:immunology; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012044:Regression Analysis; D012189:Retrospective Studies; D035781:Siblings; D014184:Transplantation, Homologous
D015703:Antigens, CD; D019002:CD56 Antigen; D016179:Granulocyte Colony-Stimulating Factor