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. 2020 Jun;12(6):574-580.
doi: 10.3892/mco.2020.2027. Epub 2020 Apr 2.

High proportions of CD3+ T cells in grafts delayed lymphocyte recovery and reduced overall survival in haploidentical peripheral blood stem cell transplantation

Ying Zhang  1 , Caili Guo  1 , Chunhong Sun  1 , Ying Chen  1 , Huachao Zhu  1 , Jieying Xi  1 , Mei Zhang  1 , Pengcheng He  1 , Xiaoning Wang  1
Affiliations

High proportions of CD3+ T cells in grafts delayed lymphocyte recovery and reduced overall survival in haploidentical peripheral blood stem cell transplantation

Ying Zhang et al. Mol Clin Oncol. 2020 Jun.

Abstract

T cells in grafts serve an important role in the pathogenesis of graft versus host disease (GVHD) and immune recovery during HLA matched allogeneic stem cell transplantation. However, the role of T cells in the haploidentical peripheral blood stem cell transplantation (Haplo-PBSCT) is yet to be determined. In the present study, the role of CD3+ T cells in grafts and impact on hematopoietic and immune recovery, cytomegalovirus (CMV) reactivation, GVHD, relapse, progress free survival and overall survival (OS) were evaluated and analyzed. A total of 30 patients who underwent haplo-PBSCT were included in the present study. CD3+ T cells accounted for a median of 23.1% (range 8-47.4%) with a median dose of 299.7x106/kg (range 104-623.4). Patients were divided into two groups according to the CD3+ T cell count: Above the median (high T cell group) and below the median CD3+ T cell (low T cell group). No significant difference was identified between neutrophil and platelet recovery time between two groups (P>0.05). The mean lymphocyte recovery time of high T cell group and low T cell group were 107.07 days (95% CI 79.88-134.25), and 50.4 days (95% CI 41.42-59.38), respectively. The lymphocyte recovery time of high T cell group was higher that of low T cell group (P<0.05). No significant difference between CMV reactivation, chronic GVHD and primary disease relapse rates was observed between two groups (P>0.05). The cumulative incidence of grade II or above acute GVHD was higher in the high T groups compared with low T groups (P<0.05). The overall survival and progress free survival rates were higher in the low T cell group compared with the high T cell group (P<0.05). In conclusion, high levels of CD3+ T cells in the grafts were associated with delayed lymphocyte recovery and an increased risk of acute GVHD and decreased overall survival.

Keywords: CD3 positive T cells; graft versus host disease; haploidentical peripheral blood stem cell transplantation; lymphocyte recovery.

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Figures

Figure 1
Figure 1
Neutrophil, platelet and lymphocyte engraftment of two groups. (A) Neutrophil recovery; (B) platelet revcovery and (C) lymphocyte recovery. NS, not significant. **P>0.05.
Figure 2
Figure 2
The cumulative incidence of sustained hematopoietic recovery. (A) neutrophil recovery; (B) platelet recovery and (C) lymphocyte recovery.
Figure 3
Figure 3
CMV reactivation between two groups. CMV, cytomegalovirus.
Figure 4
Figure 4
Acute and chronic GVHD in two groups. (A) Incidence of acute GVHD. (B) Chronic incidence of chronic. GVHD, graft versus host disease.
Figure 5
Figure 5
Relapse rate in two groups.
Figure 6
Figure 6
Progress free survival and overall survival in two groups. (A) Progress free survival. (B) Overall survival.
See this image and copyright information in PMC

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