title: Non-CD34+ cells, especially CD8+ cytotoxic T cells and CD56+ natural killer cells, rather than CD34 cells, predict early engraftment and better transplantation outcomes in patients with hematologic malignancies after allogeneic peripheral stem cell transplantation.
abstract: The effect of the transplant dose of each cell subset on engraftment kinetics and transplantation outcomes was evaluated in HLA-identical allogeneic peripheral blood stem cell transplantation (PBSCT). Sixty-nine patients were included in this retrospective study. Engraftment kinetics, transplantation outcomes, and immune reconstitution up to 1 year after transplantation were analyzed according to the transplant dose of CD34+ and non-CD34+ cells, including natural killer (NK) cells and CD8+ cytotoxic T (Tc) cells. An accelerated neutrophil engraftment was strongly associated with a higher transplant dose of NK cells (12 versus 16 days, P < .001) and Tc cells (13 versus 16 days, P < .001) but not CD34+ cells (P = .442). Survival analyses revealed a favorable prognosis for patients who received a higher dose of non-CD34+ cell subsets, rather than CD34+ cells, in terms of overall survival (OS; P = .024 for NK cells and .050 for Tc cells) and nonrelapse mortality (NRM; P = .005 for NK cells, .060 for Tc cells). In addition, a higher transplant dose of NK and Tc cells was correlated with a faster lymphoid reconstitution. In multivariate analyses, rapid neutrophil engraftment was correlated with a higher transplant dose of NK cells (P = .001) and Tc cells (P = .004). Moreover, an increased OS was associated with the NK cell dose (P = .007) and chronic graft-versus-host disease (P = .009), whereas a decreased NRM was associated with the NK dose (P = .024). In conclusion, in a PBSCT setting, a higher transplant dose of NK and Tc cells accelerated neutrophil engraftment, improved the immune reconstitution, and decreased NRM, thereby increasing OS after allogeneic PBSCT.
authors.affiliation: Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Kim
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Won
authors.forename: Nan Young
authors.initials: NY
authors.lastname: Lee
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Jang Soo
authors.initials: JS
authors.lastname: Suh
authors.forename: Kyu Bo
authors.initials: KB
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology / Q000637:transplantation*; D016131:Lymphocyte Subsets / Q000276:immunology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology / Q000637:transplantation*