title: Effect of CD8⁺ cell content on umbilical cord blood transplantation in adults with hematological malignancies.
abstract: Total nucleated (TNCs) and CD34(+) cells are considered major determinants of outcome after umbilical cord blood (UCB) transplantation but the effect of other cell subtypes present in the graft is unknown. This single-center cohort study included patients with hematological malignancies who received UCB transplantation after a myeloablative conditioning regimen. UCB units were primarily selected according to cell content, both TNCs and CD34(+) cells, and also according to the degree of HLA matching. Counts of several cell subtypes of the infused UCB unit, together with HLA disparities and other patient- and transplantation-related characteristics, were analyzed by multivariable methodology for their association with myeloid and platelet engraftment, graft-versus-host disease, nonrelapse mortality (NRM), disease-free survival (DFS), and overall survival (OS). Two hundred patients (median age, 32 years) were included in the study. In multivariable analyses, a greater number of CD8(+) cells was significantly associated with better results for myeloid (P = .001) and platelet (P = .008) engraftment, NRM (P = .02), DFS (P = .007), and OS (P = .01). CD34(+) cell content was predictive of myeloid engraftment (P < .001). This study suggests that the outcome after UCB transplantation in adults with hematological malignancies could be better when UCB grafts had a greater CD8(+) cell content.
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. Electronic address: moscardo_fed@gva.es.
authors.forename: Federico
authors.initials: F
authors.lastname: Moscardó
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Sanz
authors.affiliation: Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Carbonell
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sanz
authors.affiliation: Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Larrea
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Pau
authors.initials: P
authors.lastname: Montesinos
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Lorenzo
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Vera
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Boluda
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Claudia
authors.initials: C
authors.lastname: Salazar
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Cañigral
authors.affiliation: Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Planelles
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Isidro
authors.initials: I
authors.lastname: Jarque
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Solves
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Martín
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: López
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de la Rubia
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Martínez
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Nelly
authors.initials: N
authors.lastname: Carpio
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Martínez-Cuadrón
authors.affiliation: Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Puig
authors.affiliation: Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Montoro
authors.affiliation: Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Roig
authors.affiliation: Hematopoietic Cell Transplantation Unit, Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: Guillermo F
authors.initials: GF
authors.lastname: Sanz
mesh_terms: D000293:Adolescent; D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology* / Q000637:transplantation*; D015331:Cohort Studies; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult
keywords: Adults; Cell dose; Engraftment; Hematological malignancies; Single umbilical cord blood; Transplantation