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Effect of bone marrow CD34+cells and T-cell subsets on clinical outcomes after myeloablative allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 54, pages 775–781 (2019)Cite this article

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Abstract

Donor-derived T-cells mediate graft-versus-leukemia effect, immune reconstitution, and graft-versus-host-disease (GvHD) after allogeneic hematopoietic cell transplantation (HCT). We examined the association of donor cell subsets with outcomes in recipients of myeloablative allogeneic HCT using bone marrow (BM, N = 359) grafts from 2002 to 2014 with related or unrelated donors. Analysis considered pre-infusion graft total nucleated cell (TNC), CD34+ CD3+, CD4+, CD8+ doses. Most patients received busulfan-cyclophosphamide or etoposide-total body irradiation conditioning for acute leukemia or myelodysplastic syndrome. Calcineurin inhibitor-mycophenolate mofetil (CNI-MMF) (49%) or calcineurin inhibitor-methotrexate (CNI-MTX) (47%) were used for GvHD prophylaxis. In multivariable analysis, higher CD34+ dose was associated with platelet engraftment (P < 0.001) and lymphocyte recovery (P = 0.006). There was no association of donor cell subsets with donor chimerism or overall survival. In conclusion, BM graft composition is associated with myeloablative allogeneic HCT outcomes and future studies to evaluate optimal graft composition are needed.

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Acknowledgements

We would like to thank all members of the Cleveland Clinic Blood and Marrow Transplant Program.

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Authors and Affiliations

  1. Blood & Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA

    Sagar S. Patel, Donna Corrigan, Brian Bolwell, Robert Dean, Rabi Hanna, Aaron T. Gerds, Brian Hill, Deepa Jagadeesh, Matt Kalaycio, Brad Pohlman, Kristin Ricci, Ronald Sobecks, Betty K. Hamilton & Navneet S. Majhail

  2. Quantitative Health Sciences, , Cleveland Clinic, Cleveland, OH, USA

    Lisa A. Rybicki

  3. Transfusion Medicine, Cleveland Clinic, Cleveland, OH, USA

    Carol Dumont, Priscilla Figueroa & Wen Lu

  4. Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA

    Hien Liu

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  1. Sagar S. Patel
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Correspondence to Navneet S. Majhail.

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Patel, S.S., Rybicki, L.A., Corrigan, D. et al. Effect of bone marrow CD34+cells and T-cell subsets on clinical outcomes after myeloablative allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 54, 775–781 (2019). https://doi.org/10.1038/s41409-018-0380-5

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  • DOI: https://doi.org/10.1038/s41409-018-0380-5

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