PMID- 36895292
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230311
IS  - 1927-1220 (Electronic)
IS  - 1927-1212 (Print)
IS  - 1927-1212 (Linking)
VI  - 12
IP  - 1
DP  - 2023 Feb
TI  - The Impact of Graft CD3(+) T-Cell Dose on the Outcome of T-Cell Replete Human 
      Leukocyte Antigen-Mismatched Allogeneic Hematopoietic Peripheral Blood Stem Cells 
      Transplantation.
PG  - 27-36
LID - 10.14740/jh1071 [doi]
AB  - BACKGROUND: Data on whether the graft CD3-positive (CD3(+)) T-cell dose in 
      T-cell-replete human leukocyte antigen (HLA)-mismatched allogeneic hematopoietic 
      peripheral blood stem cells transplantation (PBSCT) influences post-transplant 
      outcomes are controversial. METHODS: Using King Hussein Cancer Center (KHCC) 
      Blood and Marrow Transplantation (BMT) Registry database, 52 adult subjects, 
      receiving the first T-cell-replete HLA-mismatched allogeneic hematopoietic PBSCT 
      for acute leukemias or myelodysplastic syndrome, were identified, from January 
      2017 to December 2020. The cutoff value of graft CD3(+) T-cell dose was 
      identified using the receiver operating characteristic (ROC) formula and Youden's 
      analysis. Subjects were divided into two cohorts: cohort 1 with low CD3(+) T-cell 
      dose (n = 34) and cohort 2 with high CD3(+) T-cell dose (n = 18). Correlative 
      analyses were performed between CD3(+) T-cell dose and the risk of 
      graft-versus-host disease (GvHD), relapse, relapse-free survival (RFS), and 
      overall survival (OS). P-values were two-sided and considered significant when P 
      < 0.05. RESULTS: Subject covariates were displayed. Subject's characteristics 
      were comparable, except for higher nucleated cells and more female donors in the 
      high CD3(+) T-cell cohort. The 100-day cumulative incidence of acute GvHD (aGvHD) 
      was 45+/-7% and 3-year cumulative incidence of chronic GvHD (cGvHD) was 28+/-6.7%. 
      There was no statistically significant difference between the two cohorts in 
      aGvHD (50% vs. 39%, P = 0.4) or cGvHD (29% vs. 22%, P = 0.7). The 2-year 
      cumulative incidence of relapse (CIR) was 67.5+/-16.3% for low compared with 
      14.3+/-6.8% for high CD3(+) T-cell cohort (P = 0.018). Fifteen subjects relapsed 
      and 24 have died, 13 due to disease relapse. There was an improvement in 2-year 
      RFS (94% vs. 83%; P = 0.0022) and 2-year OS (91% vs. 89%; P = 0.025) in low 
      CD3(+) T-cell cohort compared with high CD3(+) T-cell cohort. Graft CD3(+) T-cell 
      dose is the only significant risk factor for relapse (P = 002), and OS (P = 
      0.030) in univariate analysis which was maintained in multivariate for relapse (P 
      = 0.003), but not for OS (P = 0.050). CONCLUSIONS: Our data suggest that high 
      graft CD3(+) T-cell dose is associated with lower risk of relapse, and might 
      improve long-term survival, but has no influence on the risk of developing aGvHD 
      or cGvHD.
CI  - Copyright 2023, Halahleh et al.
FAU - Halahleh, Khalid
AU  - Halahleh K
AD  - Hematology Oncology and Bone Marrow Transplantation, King Hussein Cancer Center, 
      Amman, Jordan.
FAU - Mustafa, Rawan
AU  - Mustafa R
AD  - Department of Internal Medicine, Hematology Oncology Section, King Hussein Cancer 
      Center, Amman, Jordan.
FAU - Sarhan, Dania
AU  - Sarhan D
AD  - Cell Therapy and Applied Genomics (CTAG Lab) laboratory, King Hussein Cancer 
      Center, Amman, Jordan.
FAU - Al Rimawi, Dalia
AU  - Al Rimawi D
AD  - Biostatistics Unit, Research Office, King Hussein Cancer Center, Amman, Jordan.
FAU - Abdelkhaleq, Hadeel
AU  - Abdelkhaleq H
AD  - Biostatistics Unit, Research Office, King Hussein Cancer Center, Amman, Jordan.
FAU - Muradi, Isra
AU  - Muradi I
AD  - Department of Internal Medicine, University of Tripoli, Tripoli, Libya 
      Jamahiriya.
FAU - Sultan, Iyad
AU  - Sultan I
AD  - Department of Pediatrics, Hematology and Medical Oncology, King Hussein Cancer 
      Center, Amman, Jordan.
LA  - eng
PT  - Journal Article
DEP - 20230225
PL  - Canada
TA  - J Hematol
JT  - Journal of hematology
JID - 101635099
PMC - PMC9990716
OTO - NOTNLM
OT  - Allogeneic hematopoietic cell transplantation
OT  - Graft CD3+ T-cell dose
OT  - GvHD
OT  - Overall survival
OT  - PBSC
OT  - Relapse-free survival
COIS- The authors declare that they have no conflict of interest.
EDAT- 2023/03/11 06:00
MHDA- 2023/03/11 06:01
PMCR- 2023/02/25
CRDT- 2023/03/10 02:25
PHST- 2022/10/24 00:00 [received]
PHST- 2022/12/16 00:00 [accepted]
PHST- 2023/03/10 02:25 [entrez]
PHST- 2023/03/11 06:00 [pubmed]
PHST- 2023/03/11 06:01 [medline]
PHST- 2023/02/25 00:00 [pmc-release]
AID - 10.14740/jh1071 [doi]
PST - ppublish
SO  - J Hematol. 2023 Feb;12(1):27-36. doi: 10.14740/jh1071. Epub 2023 Feb 25.