Cord blood graft composition impacts the clinical outcome of allogeneic stem cell transplantation.
BACKGROUND
Despite routine use of umbilical cord blood (CB) grafts as stem cell source for allogeneic stem cell transplantations, much remains unknown regarding their cell composition and correlation with clinical outcome.


METHODS
We analyzed material from 30 CB units used for allogeneic hematopoietic stem cell transplantation by multicolor flow cytometry. Phenotypic data were correlated with various clinical outcomes such as survival, graft-versus-host disease (GVHD), relapse, rejection, viral reactivation, and bacteremia.


RESULTS
We found that above-median frequencies of CD69+ T cells, naïve CD8+ T cells, and CD127+ B cells in the CB graft were each associated with significantly improved patient survival. Moreover, a statistically significant correlation was seen between higher levels of CD94+ T cells and herpes simplex virus and varicella zoster virus reactivation post transplantation. A similar correlation was seen for the frequency of CD95+ cells in total CD3+, as well as CD4+ and CD8+ T-cell subsets, and viral reactivation. Finally, a higher frequency of naïve CD8+ T cells was associated with the incidence of acute GVHD.


CONCLUSIONS
Our study highlights the importance of further exploration of graft composition before CB transplantation as a tool for risk prediction.
Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Immunology and Transfusion Science, Karolinska University Hospital, Stockholm, Sweden.
H
H
Wikell
S
S
Ponandai-Srinivasan
J
J
Mattsson
J
J
Gertow
M
M
Uhlin
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D001402:B-Lymphocytes / Q000737:chemistry*; D017252:CD3 Complex / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes; D018414:CD8-Positive T-Lymphocytes; D002648:Child; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D007223:Infant; D053699:Interleukin-7 Receptor alpha Subunit / Q000032:analysis; D037181:Lectins, C-Type / Q000032:analysis; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D051920:NK Cell Lectin-Like Receptor Subfamily D / Q000032:analysis; D018139:Simplexvirus / Q000502:physiology; D015996:Survival Rate; D013601:T-Lymphocytes / Q000737:chemistry*; D014184:Transplantation, Homologous; D014775:Virus Activation / Q000276:immunology*; D055815:Young Adult; D019014:fas Receptor / Q000032:analysis; D000099192:CD69 Antigens
D015703:Antigens, CD; D000945:Antigens, Differentiation, T-Lymphocyte; D017252:CD3 Complex; D053699:Interleukin-7 Receptor alpha Subunit; D037181:Lectins, C-Type; D051920:NK Cell Lectin-Like Receptor Subfamily D; D019014:fas Receptor; D000099192:CD69 Antigens
allogeneic stem cell transplantation; clinical outcome; cord blood; graft composition