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Lymphocyte expansion after unrelated cord blood allogeneic stem cell transplantation in adults

Bone Marrow Transplantation volume 52, pages 854–858 (2017)Cite this article

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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.

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Author notes

  1. M C Béné and P Chevallier: These authors contributed equally to this work.

Authors and Affiliations

  1. Hematology Biology, University Hospital, Nantes, France

    Y Le Bris, A Ménard, C Debord, N Robillard, M Eveillard, S Wuillème & M C Béné

  2. Department of Hematology, University Hospital, Nantes, France

    T Guillaume, P Peterlin, J Delaunay, A Garnier, P Moreau & P Chevallier

  3. Virology, University Hospital, Nantes, France

    M Illiaquer

  4. Immunology, University Hospital, Nantes, France

    J Martin

  5. Etablissement Français du Sang, Nantes, France

    S Malard & A Duquesne

  6. Hôpital Saint-Antoine, Paris University UPMC, INSERM U938, Paris, France

    M Mohty

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  1. Y Le Bris
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  2. T Guillaume
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  15. A Garnier
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  16. P Moreau
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  17. M C Béné
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  18. P Chevallier
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Correspondence to Y Le Bris.

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The authors declare no conflict of interest.

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Le Bris, Y., Guillaume, T., Ménard, A. et al. Lymphocyte expansion after unrelated cord blood allogeneic stem cell transplantation in adults. Bone Marrow Transplant 52, 854–858 (2017). https://doi.org/10.1038/bmt.2016.364

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  • DOI: https://doi.org/10.1038/bmt.2016.364

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