title: Lymphocyte expansion after unrelated cord blood allogeneic stem cell transplantation in adults.
abstract: Limited information is available regarding the incidence and features of lymphocyte expansions after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Large granular lymphocytes (LGL) expansions have been reported after bone marrow or peripheral blood, but not after unrelated cord blood (UCB) allo-HSCT, associated with indolent clinical courses and favorable outcomes. Here, we considered 85 recipients of UCB allo-HSCT to more broadly define the impact of lymphocytosis, not limited to LGL. Sustained lymphocytosis was observed in 21 (25%) patients at a median onset of 12.6 months and with a median duration of 12 months. Immunophenotypic analysis showed predominantly CD8+T and/or polyclonal B-cell expansions. Three patients only had monoclonal T-cell expansion. CMV reactivation was significantly more frequent in the group of patients with lymphocytosis (76% vs 28%, P=0.0001), but was not associated with survival. Conversely, 2-year disease-free survival and overall survival were significantly higher for lymphocytosis patients (85% vs 55%, P=0.01 and 85% vs 63%, P=0.03, respectively). In conclusion, expansion of T or B lymphocytes after UCB allo-HSCT in adults is not a rare event. Although occurring relatively late after transplant, this feature is predictive of a better outcome for the patients.
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Bris
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: T
authors.initials: T
authors.lastname: Guillaume
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Ménard
authors.affiliation: Virology, University Hospital, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Illiaquer
authors.affiliation: Immunology, University Hospital, Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Martin
authors.affiliation: Etablissement Français du Sang, Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Malard
authors.affiliation: Etablissement Français du Sang, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Duquesne
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Peterlin
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Debord
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: N
authors.initials: N
authors.lastname: Robillard
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Eveillard
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Wuillème
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Delaunay
authors.affiliation: Hôpital Saint-Antoine, Paris University UPMC, INSERM U938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Garnier
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Moreau
authors.affiliation: Hematology Biology, University Hospital, Nantes, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Béné
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism*; D036101:Cord Blood Stem Cell Transplantation; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate