title: B-cell concentration in the apheretic product predicts acute graft-versus-host disease and treatment-related mortality of allogeneic peripheral blood stem cell transplantation.
abstract: BACKGROUND
  The influence of the graft composition on the clinical outcome after allogeneic peripheral blood stem cell (PBSC) transplantation is not well established.
  
  
  METHODS
  The cellular composition of the apheretic products obtained from 63 human leukocyte antigen-identical siblings was prospectively correlated with the outcome of patients with hematological malignancies undergoing an allogeneic PBSC transplant after myeloablative conditioning. The concentration of nuclear, mononuclear, CD34+, T-cell subsets, B cells, and natural killer cells in the graft has been analyzed.
  
  
  RESULTS
  In univariate analysis, acute graft-versus-host disease (GVHD) correlated with the disease (P=0.002), with the phase of disease at transplant (P=0.01), and with the number of CD20+ cells infused (P=0.05). In multivariate analysis, a dose of CD20+ cells in the graft higher than the median dose remained the only factor negatively affecting the incidence of acute GVHD (P=0.01; 95% confidence interval [CI]: 0.12-0.78). In univariate analysis, treatment-related mortality (TRM) correlated with the disease (P=0.04) and was negatively affected by a dose of infused B cells greater than the median value (28% versus 50%; P=0.02). In multivariate analysis, TRM was close to statistical correlation with the dose of CD20+ cells (P=0.06; 95% CI: 0.02-1.05). No other clinical parameter was influenced by the composition of the graft.
  
  
  CONCLUSIONS
  Our results suggest that the concentration of B cells in the apheretic product may predict the incidence of acute GVHD and TRM in patients undergoing an allogeneic PBSC transplantation and open the way to the new preventive and therapeutic strategies for the management of GVHD.
authors.affiliation: Division of Hematology, Department of Cellular Biotechnologies and Haematology, University La Sapienza, Rome, Italy. iori@bce.uniroma1.it
authors.forename: Anna P
authors.initials: AP
authors.lastname: Iori
authors.forename: Giovanni F
authors.initials: GF
authors.lastname: Torelli
authors.forename: Maria S
authors.initials: MS
authors.lastname: De Propris
authors.forename: Filippo
authors.initials: F
authors.lastname: Milano
authors.forename: Simonetta
authors.initials: S
authors.lastname: Pupella
authors.forename: Maria
authors.initials: M
authors.lastname: Gozzer
authors.forename: Francesca
authors.initials: F
authors.lastname: Mancini
authors.forename: Maria L
authors.initials: ML
authors.lastname: Milani
authors.forename: Stefania
authors.initials: S
authors.lastname: Intoppa
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cerretti
authors.forename: Barbarella
authors.initials: B
authors.lastname: Lucarelli
authors.forename: Veronica
authors.initials: V
authors.lastname: Valle
authors.forename: Luigi
authors.initials: L
authors.lastname: Malandruccolo
authors.forename: Emilia
authors.initials: E
authors.lastname: Iannella
authors.forename: Eva
authors.initials: E
authors.lastname: Arleo
authors.forename: Anna
authors.initials: A
authors.lastname: Guarini
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001402:B-Lymphocytes / Q000166:cytology* / Q000276:immunology*; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality*; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012008:Recurrence; D014184:Transplantation, Homologous / Q000009:adverse effects