title: Cord Blood Units with High CD3(+) Cell Counts Predict Early Lymphocyte Recovery After In Vivo T Cell-Depleted Single Cord Blood Transplantation.
abstract: Although high absolute lymphocyte count (ALC) early after transplantation is a simple surrogate for immune reconstitution, few studies to date have established the predictive factors for ALC after umbilical cord blood transplantation (UCBT). We retrospectively studied the factors associated with early lymphocyte recovery and the impact of the ALC on day +42 (ALC42) of ≥300 × 10(6)/L on outcomes in 210 consecutive pediatric and adult patients (112 males; median age, 15 years; range, 0.3 to 60 years; interquartile range, 4 to 36 years) who underwent myeloablative in vivo T cell-depleted single UCBT between 2005 and 2014 for malignant and nonmalignant disorders. In a logistic multivariate regression model, factors favoring a higher ALC42 were higher infused CD3(+) cell dose (odds ratio [OR], 2.7; 95% CI, 1.4 to 5.2; P = .004), lower antithymocyte globulin dose (OR, 2.3; 95% CI, 1.2 to 4.5; P = .01), and better HLA match (OR, 2.1; 95% CI, 1.1 to 4.1; P = .03). In multivariate analysis, lower ALC42 was associated with higher nonrelapse mortality (hazard ratio [HR], 1.76; 95% CI, 1.34 to 2.32; P = .001), whereas a higher ALC42 was associated with better disease-free survival (HR, 2.03; 95% CI, 1.15 to 3.6; P < .001) and overall survival (HR, 2.03; 95% CI, 1.17 to 3.6; P < .001). Our study suggests that the selection of better HLA-matched cord blood units containing higher CD3(+) cell counts and the use of conditioning regimens with lower ATG doses could improve immune reconstitution after UCBT.
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain. Electronic address: ncastillo@bst.cat.
authors.forename: Nerea
authors.initials: N
authors.lastname: Castillo
authors.affiliation: Adult Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: García-Cadenas
authors.affiliation: Pediatric Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Díaz-Heredia
authors.affiliation: Adult Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Barba
authors.affiliation: Institut Català d'Oncologia-Badalona, Barcelona, Spain.
authors.forename: Christelle
authors.initials: C
authors.lastname: Ferrà
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Canals
authors.affiliation: Pediatric Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Izaskun
authors.initials: I
authors.lastname: Elorza
authors.affiliation: Pediatric Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Olivé
authors.affiliation: Pediatric Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Badell
authors.affiliation: Adult Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.affiliation: Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Valcárcel
authors.affiliation: Banc de Sang i Teixits, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Querol
mesh_terms: D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D017252:CD3 Complex / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005312:Fetal Blood / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018655:Lymphocyte Count; D008212:Lymphocyte Depletion; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013601:T-Lymphocytes / Q000166:cytology*; D019172:Transplantation Conditioning / Q000379:methods; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D017252:CD3 Complex
keywords: Lymphocyte recovery; T cell depletion; Umbilical cord blood transplantation