B-cell concentration in the apheretic product predicts acute graft-versus-host disease and treatment-related mortality of allogeneic peripheral blood stem cell transplantation.
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.
Iori
Anna P
AP
Division of Hematology, Department of Cellular Biotechnologies and Haematology, University La Sapienza, Rome, Italy. iori@bce.uniroma1.it
Torelli
Giovanni F
GF
De Propris
Maria S
MS
Milano
Filippo
F
Pupella
Simonetta
S
Gozzer
Maria
M
Mancini
Francesca
F
Milani
Maria L
ML
Intoppa
Stefania
S
Cerretti
Raffaella
R
Lucarelli
Barbarella
B
Valle
Veronica
V
Malandruccolo
Luigi
L
Iannella
Emilia
E
Arleo
Eva
E
Guarini
Anna
A
Foà
Robin
R
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