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Clinical Trial
. 2012 May;18(5):794-804.
doi: 10.1016/j.bbmt.2011.10.011. Epub 2011 Oct 17.

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

Amir A Toor  1 , Roy T Sabo, Harold M Chung, Catherine Roberts, Rose H Manjili, Shiyu Song, David C Williams Jr, Wendy Edmiston, Mandy L Gatesman, Richard W Edwards, Andrea Ferreira-Gonzalez, William B Clark, Michael C Neale, John M McCarty, Masoud H Manjili
Affiliations
Clinical Trial

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

Amir A Toor et al. Biol Blood Marrow Transplant. 2012 May.

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.

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Figures

Figure 1
Figure 1
Area Under Curve (AUC) for Receiver Operating Characteristic (ROC) curves for GVHD status, remission status, and whole-blood chimerism against ddCD3 group. Table depicting ddCD3 cutoff calculated from sum of AUC for different ROC curves.
Figure 2
Figure 2
A: Kaplan Meier survival curve for overall survival time, comparing ddCD3 Hi (>110) and Lo (<110) groups. B: Kaplan Meier survival curve for progression free survival time, comparing ddCD3 Hi (>110) and Lo (<110) groups. C: Kaplan Meier failure curve for time to relapse, comparing ddCD3 Hi (>110) and Lo (<110) groups.
Figure 2
Figure 2
A: Kaplan Meier survival curve for overall survival time, comparing ddCD3 Hi (>110) and Lo (<110) groups. B: Kaplan Meier survival curve for progression free survival time, comparing ddCD3 Hi (>110) and Lo (<110) groups. C: Kaplan Meier failure curve for time to relapse, comparing ddCD3 Hi (>110) and Lo (<110) groups.
Figure 3
Figure 3
A: T cell chimerism trend in patients with mixed chimerism and ddCD3 <110/μL. B: T cell chimerism trend in patients with mixed chimerism and ddCD3 >110/μL. C: Effect of ddCD3 count at 8 weeks on T cell chimerism at 24 weeks. D: Trends in ddCD3 count over time in the high and low recovery groups.
Figure 3
Figure 3
A: T cell chimerism trend in patients with mixed chimerism and ddCD3 <110/μL. B: T cell chimerism trend in patients with mixed chimerism and ddCD3 >110/μL. C: Effect of ddCD3 count at 8 weeks on T cell chimerism at 24 weeks. D: Trends in ddCD3 count over time in the high and low recovery groups.
Figure 4
Figure 4
Effect of immunosuppression withdrawal on granulocyte chimerism in patients with high or low ddCD3.
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References

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