Effect of graft composition on the prognosis of allogeneic hematopoietic stem cell transplantation
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R730.54

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    Abstract:

    Objective:To investigate the impact of the graft content including mononuclear cells(MNC),CD34+ cells and T-lymphocyte subsets on post-transplant survival. Methods:A retrospective analysis of 121 patients with hematologic malignant diseases undergoing allogeneic hematopoietic stem cell transplantation(allo -HSCT)was performed to investigate the effects of the doses of MNC,CD34 + cells,CD3+ T cells,CD4+ T cells,CD8+ T cells and regulatory T(Treg)cells in the grafts on hematopoietic reconstitution and survival. Results:Neutrophils were successfully engrafted in 120 patients,and patients with high doses of CD34+ cells(≥6.90×106 /kg)(P < 0.001), CD3+ T cells(≥6.24×108 /kg)(P=0.042)and CD8+ T cells(≥1.05×108 /kg)(P=0.021)had more rapid engraftment of neutrophils. Platelets were successfully engrafted in 119 cases,and high dose CD34 + cells were associated with faster platelet reconstruction(P=0.001). Acute graft-versus-host disease(aGVHD)occurred in 53(43.8%)patients and 28 patients had chronic graft-versus-host disease (cGVHD). One and 3-year overall survival(OS)rates were 83.5% and 68.0%,and one and 3-year progression -free survival(PFS) rates were 75.0% and 64.4%. In univariate analysis,the patients with high MNC dose(≥9.79×108 /kg),high CD3 + T cells dose and CD4+ /CD8+ T cells <3.57 had better OS and the high MNC group had better PFS(P=0.061). Multivariate analysis showed that the CD4+ / CD8+ T-cell < 3.57 group had better OS(HR=0.288,95%CI:0.084~0.988,P=0.048). One and 3-year cumulative incidence of relapse(CIR)were 18.2% and 26.8%,respectively. Patients in the higher MNC and CD8 + T -cell groups had lower CIR. Conclusion:Graft components has an important impact on the prognosis of allo-HSCT. High doses of CD34+ cells promote faster platelet implantation, and patients with a CD4+ /CD8+ T-cell ratio < 3.57 in the graft have better OS and lower CIR.

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LIU Yanping, LI Fang, WANG Jiawen, QIAN Sixuan, WU Hanxin, LU Hua, ZHU Yu, SHEN Wenyi, HONG Ming, CHEN Lijuan, LI Jianyong, MIAO Kourong, ZHU Han. Effect of graft composition on the prognosis of allogeneic hematopoietic stem cell transplantation[J].,2023,(7):974-980.

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  • Received:October 08,2022
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  • Online: July 16,2023
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