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01-06-2020 | Graft-Versus-Host Disease | Original Article

Absence of influence of peripheral blood CD34+ and CD3+ graft cell counts on outcomes after reduced-intensity conditioning transplantation using post-transplant cyclophosphamide

Authors: Alice Garnier, Thierry Guillaume, Pierre Peterlin, Amandine Le Bourgeois, Béatrice Mahé, Viviane Dubruille, Nicolas Blin, Cyrille Touzeau, Thomas Gastinne, Anne Lok, Benoit Tessoulin, Alix Duquesne, Marion Eveillard, Steven Le Gouill, Philippe Moreau, Marie C. Béné, Patrice Chevallier

Published in: Annals of Hematology | Issue 6/2020

Abstract

The influence of peripheral blood stem cell (PBSC) graft cell contents after transplant with post-transplant cyclophosphamide (PTCY) remains unclear. Here, we retrospectively report on a cohort of 77 adults who received a Baltimore-based reduced-intensity conditioning regimen either with fludarabine (n = 40) or clofarabine (n = 37) and PTCY. With a median follow-up of 29.2 months, [2-]year overall (OS), disease-free (DFS), and GVHD/relapse-free survival (GRFS) rates were 62.8%, 51%, and 36.7%, respectively. The incidence of grades [2–]4 acute GVHD was significantly higher in patients transplanted with a haplodonor (n = 56), at 57.1% vs 19% (p = 0.006). PBSC graft cell contents (CD45+, CD34+, and CD3+ cells) had no impact on any outcome. Considering immune reconstitution until 1 year, only monocytes were above the normal range (as early as day + 30) during the first year post-transplant. In multivariate analysis, an older donor (> 45 years) and a high/very high disease risk index were independently associated with lower OS. A higher monocyte count (> median) at day + 90 was also associated with better OS, DFS, and GRFS. Donor/recipient CMV status matching was independently associated with GRFS. In conclusion, our data support the fact that there is no need to manipulate the graft before infusion in the particular context of PBSC/PTCY Baltimore-based allotransplant.

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Title: Absence of influence of peripheral blood CD34+ and CD3+ graft cell counts on outcomes after reduced-intensity conditioning transplantation using post-transplant cyclophosphamide
Authors: Alice Garnier
Thierry Guillaume
Pierre Peterlin
Amandine Le Bourgeois
Béatrice Mahé
Viviane Dubruille
Nicolas Blin
Cyrille Touzeau
Thomas Gastinne
Anne Lok
Benoit Tessoulin
Alix Duquesne
Marion Eveillard
Steven Le Gouill
Philippe Moreau
Marie C. Béné
Patrice Chevallier
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Graft-Versus-Host Disease
Graft-Versus-Host Disease
Published in: Annals of Hematology / Issue 6/2020
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-020-04031-4

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