Lymphocyte expansion after unrelated cord blood allogeneic stem cell transplantation in adults.

Abstract:

:Limited information is available regarding the incidence and features of lymphocyte expansions after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Large granular lymphocytes (LGL) expansions have been reported after bone marrow or peripheral blood, but not after unrelated cord blood (UCB) allo-HSCT, associated with indolent clinical courses and favorable outcomes. Here, we considered 85 recipients of UCB allo-HSCT to more broadly define the impact of lymphocytosis, not limited to LGL. Sustained lymphocytosis was observed in 21 (25%) patients at a median onset of 12.6 months and with a median duration of 12 months. Immunophenotypic analysis showed predominantly CD8+ T and/or polyclonal B-cell expansions. Three patients only had monoclonal T-cell expansion. CMV reactivation was significantly more frequent in the group of patients with lymphocytosis (76% vs 28%, P=0.0001), but was not associated with survival. Conversely, 2-year disease-free survival and overall survival were significantly higher for lymphocytosis patients (85% vs 55%, P=0.01 and 85% vs 63%, P=0.03, respectively). In conclusion, expansion of T or B lymphocytes after UCB allo-HSCT in adults is not a rare event. Although occurring relatively late after transplant, this feature is predictive of a better outcome for the patients.

journal_name

Bone Marrow Transplant

authors

Le Bris Y,Guillaume T,Ménard A,Illiaquer M,Martin J,Malard S,Duquesne A,Peterlin P,Debord C,Robillard N,Eveillard M,Wuillème S,Delaunay J,Mohty M,Garnier A,Moreau P,Béné MC,Chevallier P

doi

10.1038/bmt.2016.364

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

854-858

issue

6

eissn

0268-3369

issn

1476-5365

pii

bmt2016364

journal_volume

52

pub_type

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