TY - JOUR
T1 - Lymphocyte expansion after unrelated cord blood allogeneic stem cell transplantation in adults
AU - Le Bris, Y.
AU - Guillaume, T.
AU - Ménard, A.
AU - Illiaquer, M.
AU - Martin, J.
AU - Malard, S.
AU - Duquesne, A.
AU - Peterlin, P.
AU - Debord, C.
AU - Robillard, N.
AU - Eveillard, M.
AU - Wuillème, S.
AU - Delaunay, J.
AU - Mohty, M.
AU - Garnier, A.
AU - Moreau, P.
AU - Béné, M. C.
AU - Chevallier, P.
N1 - Publisher Copyright:
© 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85010991934
U2 - 10.1038/bmt.2016.364
DO - 10.1038/bmt.2016.364
M3 - Article
C2 - 28134920
AN - SCOPUS:85010991934
SN - 0268-3369
VL - 52
SP - 854
EP - 858
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 6
ER -