Favorable outcomes in patients with high donor-derived T cell count after in vivo T cell-depleted reduced-intensity allogeneic stem cell transplantation

Biol Blood Marrow Transplant. 2012 May;18(5):794-804. doi: 10.1016/j.bbmt.2011.10.011. Epub 2011 Oct 17.

Abstract

Patients with hematologic malignancies were conditioned using a rabbit antithymocyte globulin-based reduced-intensity conditioning regimen for allogeneic stem cell transplantation. Donor-derived CD3(+) cell count (ddCD3), a product of CD3(+) cell chimerism and absolute CD3(+) cell count, when <110/μL at 8 weeks post-stem cell transplantation predicted a high risk of sustained mixed chimerism and relapse. Alternatively, patients with a higher ddCD3 developed graft-versus-host disease more frequently, and when partially chimeric, had higher rates of conversion to full donor chimerism after withdrawal of immunosuppression. Early data from our small cohort of patients indicate that ddCD3 at 8 weeks may be used to guide decisions regarding withdrawal of immunosuppression and administration of donor lymphocyte infusion in partially T cell-depleted reduced-intensity regimens.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Animals
  • Antilymphocyte Serum / pharmacology
  • CD3 Complex / immunology
  • Chimerism
  • Cohort Studies
  • Graft Survival
  • Graft vs Host Disease / prevention & control
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use
  • Lymphocyte Count
  • Lymphocyte Depletion
  • Middle Aged
  • Rabbits
  • Recurrence
  • Survival Rate
  • T-Lymphocytes / cytology
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology*
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous*
  • Treatment Outcome

Substances

  • Antilymphocyte Serum
  • CD3 Complex
  • Immunosuppressive Agents