Association of bone marrow natural killer cell dose with neutrophil recovery and chronic graft-versus-host disease after HLA identical sibling bone marrow transplants.
Allogeneic bone marrow (BM) transplant (BMT) outcomes have been correlated with the infused nucleated, CD34(+), and T- cell dose. The potential impact of natural killer (NK) BM infused cell dose has however not been established. We analysed the outcomes of 78 patients receiving an HLA identical BMT. A higher NK cell dose was associated with the speed of neutrophil (P = 0.05) and platelet recovery (P = 0.04). Higher nucleated cells, CD34(+), CD3(+), CD3(+)/4(+), CD3(+)/8(+) and NK cell dose were associated with a lower incidence of chronic GvHD (cGvHD) in univariate analysis. In multivariate analysis, the risk of cGvHD was increased by a lower NK cell dose [hazard ratio (HR) = 2.3 (1.2-4.4) for cell dose <0.9 x 10(6)/kg; P = 0.01] and an older age [HR = 1.4 /10 years (1.1-1.8); P = 0.002]. In addition, a higher CD3(+)/4(+) and NK cell dose were associated with a decreased incidence of viral infections (P = 0.03 and P = 0.06 respectively). No specific cell subpopulation infused dose was associated with survival. In conclusion, a higher BM NK cell dose is associated with an increased speed of neutrophil recovery and a decreased incidence of cGvHD.
Larghero
Jerome
J
Cell Therapy Unit, Assistance Publique-Hôpitaux de Paris, Saint Louis Hospital, Paris, France.
Rocha
Vanderson
V
Porcher
Raphael
R
Filion
Alain
A
Ternaux
Brigitte
B
Lacassagne
Marie-Noelle
MN
Robin
Marie
M
Peffault de Latour
Regis
R
Devergie
Agnes
A
Biscay
Nicole
N
Ribaud
Patricia
P
Benbunan
Marc
M
Gluckman
Eliane
E
Marolleau
Jean Pierre
JP
Socié
Gerard
G
D000328:Adult; D001424:Bacterial Infections / Q000150:complications; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002908:Chronic Disease; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D007694:Killer Cells, Natural / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D009181:Mycoses / Q000150:complications; D009504:Neutrophils / Q000276:immunology*; D016016:Proportional Hazards Models; D014185:Transplantation, Isogeneic; D014777:Virus Diseases / Q000150:complications