Effect of CD8+ Cell Content on Umbilical Cord Blood Transplantation in Adults with Hematological Malignancies
Effect of CD8+ Cell Content on Umbilical Cord Blood Transplantation in Adults with Hematological Malignancies
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DOI：
10.1016/j.bbmt.2014.06.038
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发表时间：
2014-11-01
影响因子：
4.3
通讯作者：
Sanz, Guillermo F.
中科院分区：
文献类型：
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作者：
Moscardo, Federico;Sanz, Jaime;Sanz, Guillermo F.
总有核细胞 (TNC) 和 CD34(+) 细胞被认为是脐带血 (UCB) 移植后结果的主要决定因素，但移植物中存在的其他细胞亚型的影响尚不清楚。这项单中心队列研究纳入了在清髓性预处理方案后接受 UCB 移植的血液恶性肿瘤患者。 UCB单位主要根据细胞含量（TNC和CD34+细胞）以及HLA匹配程度来选择。通过多变量方法分析输注 UCB 单位的几种细胞亚型计数以及 HLA 差异和其他患者和移植相关特征，分析它们与骨髓和血小板植入、移植物抗宿主病、非复发死亡率 (NRM)、无病生存 (DFS) 和总生存 (OS) 的关系。该研究纳入了 200 名患者（中位年龄 32 岁）。在多变量分析中，更多数量的 CD8(+) 细胞与更好的骨髓 (P = .001) 和血小板 (P = .008) 植入、NRM (P = .02)、DFS (P = .007) 和 OS (P = .01) 结果显着相关。 CD34(+) 细胞含量可预测骨髓移植 (P < .001)。这项研究表明，当 UCB 移植物具有更高的 CD8(+) 细胞含量时，患有血液恶性肿瘤的成人进行 UCB 移植后的结果可能会更好。 (C) 2014 年美国血液和骨髓移植学会。
Total nucleated (TNCs) and CD34(+) cells are considered major determinants of outcome after umbilical cord blood (UCB) transplantation but the effect of other cell subtypes present in the graft is unknown. This single-center cohort study included patients with hematological malignancies who received UCB transplantation after a myeloablative conditioning regimen. UCB units were primarily selected according to cell content, both TNCs and CD34(+) cells, and also according to the degree of HLA matching. Counts of several cell subtypes of the infused UCB unit, together with HLA disparities and other patient- and transplantation-related characteristics, were analyzed by multivariable methodology for their association with myeloid and platelet engraftment, graft-versus-host disease, nonrelapse mortality (NRM), disease-free survival (DFS), and overall survival (OS). Two hundred patients (median age, 32 years) were included in the study. In multivariable analyses, a greater number of CD8(+) cells was significantly associated with better results for myeloid (P = .001) and platelet (P = .008) engraftment, NRM (P = .02), DFS (P = .007), and OS (P = .01). CD34(+) cell content was predictive of myeloid engraftment (P < .001). This study suggests that the outcome after UCB transplantation in adults with hematological malignancies could be better when UCB grafts had a greater CD8(+) cell content. (C) 2014 American Society for Blood and Marrow Transplantation.