Complete Donor T Cell Chimerism Predicts Lower Relapse Incidence after Standard Double Umbilical Cord Blood Reduced-Intensity Conditioning Regimen Allogeneic Transplantation in Adults
Abstract
Double umbilical cord blood (dUCB) allogeneic transplantation after a low-dose total body irradiation, cyclophosphamide, and fludarabine (TCF)-based reduced-intensity conditioning regimen (RIC) is increasingly used in adults lacking a suitable related or unrelated donor. Currently, there are little data regarding the long-term outcome of CD3(+) T cell chimerism (TCC) in this particular setting. Thirty-six adults with various hematological diseases who received dUCB allogeneic transplants conditioned with TCF were included in this retrospective study. Peripheral blood CD3(+) TCC was considered until day +100 after transplantation to determine the impact of full versus mixed chimerism on long-term outcomes. Twenty-nine and 7 patients were documented with full and mixed CD3(+) TCC, respectively, within the first 100 days after transplantation. With a median follow-up of 36 months, 3 year-overall survival (OS), disease-free survival (DFS), and cumulative incidence of relapse (CIR) were 61%, (95% confidence interval [CI], 43% to 75%); 50% (95% CI, 32.5% to 66%), and 28% (95% CI, 16% to 44%), respectively. In univariate analysis, a full CD3(+) TCC was associated with a better 3-year DFS: 59% (95% CI, 39% to 75.5%) versus 14% (95% CI, 7% to 46%); hazard ratio (HR), .24 (.09 to .65); P = .005 and a lower CIR: 24% (95% CI, 21.5% to 57%) versus 78% (95% CI, 52% to 99%); HR, .18 (.05 to .50); P = .004. In multivariate analysis, a full CD3(+) TCC remained associated with a lower CIR (HR, .17 [.028 to .99]; P = .049). CD3(+) TCC has no impact on graft-versus-host disease and nonrelapse mortality in this study. In conclusion, here, full CD3(+) TCC was independently associated with a lower risk of relapse in adults receiving a dUCB TCF RIC allogeneic transplantation. This highlights the need to develop immunotherapy approaches allowing for early conversion to full chimerism after this type of transplantation.
Related
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BibTeX
@article{peterlin2026complete,
title = {{Complete Donor T Cell Chimerism Predicts Lower Relapse Incidence after Standard Double Umbilical Cord Blood Reduced-Intensity Conditioning Regimen Allogeneic Transplantation in Adults}},
author = {Pierre Peterlin and Jacques Delaunay and Thierry Guillaume and Thomas Gastinne and Béatrice Mahé and Viviane Dubruille and Nicolas Blin and Amandine Le Bourgeois and Eolia Brissot and Laurence Lodé and Steven Le Gouill and Philippe Moreau and Mohamad Mohty and Patrice Chevallier},
journal = {Biology of Blood and Marrow Transplantation},
year = {2026},
month = sep,
doi = {10.1016/j.bbmt.2014.08.018},
url = {https://nantes-universite.hal.science/hal-05745265v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Complete Donor T Cell Chimerism Predicts Lower Relapse Incidence after Standard Double Umbilical Cord Blood Reduced-Intensity Conditioning Regimen Allogeneic Transplantation in Adults
AU - Pierre Peterlin
AU - Jacques Delaunay
AU - Thierry Guillaume
AU - Thomas Gastinne
AU - Béatrice Mahé
AU - Viviane Dubruille
AU - Nicolas Blin
AU - Amandine Le Bourgeois
AU - Eolia Brissot
AU - Laurence Lodé
AU - Steven Le Gouill
AU - Philippe Moreau
AU - Mohamad Mohty
AU - Patrice Chevallier
PY - 2026
DA - 2026/09/10
JO - Biology of Blood and Marrow Transplantation
DO - 10.1016/j.bbmt.2014.08.018
UR - https://nantes-universite.hal.science/hal-05745265v1
AB - Double umbilical cord blood (dUCB) allogeneic transplantation after a low-dose total body irradiation, cyclophosphamide, and fludarabine (TCF)-based reduced-intensity conditioning regimen (RIC) is increasingly used in adults lacking a suitable related or unrelated donor. Currently, there are little data regarding the long-term outcome of CD3(+) T cell chimerism (TCC) in this particular setting. Thirty-six adults with various hematological diseases who received dUCB allogeneic transplants conditioned with TCF were included in this retrospective study. Peripheral blood CD3(+) TCC was considered until day +100 after transplantation to determine the impact of full versus mixed chimerism on long-term outcomes. Twenty-nine and 7 patients were documented with full and mixed CD3(+) TCC, respectively, within the first 100 days after transplantation. With a median follow-up of 36 months, 3 year-overall survival (OS), disease-free survival (DFS), and cumulative incidence of relapse (CIR) were 61%, (95% confidence interval [CI], 43% to 75%); 50% (95% CI, 32.5% to 66%), and 28% (95% CI, 16% to 44%), respectively. In univariate analysis, a full CD3(+) TCC was associated with a better 3-year DFS: 59% (95% CI, 39% to 75.5%) versus 14% (95% CI, 7% to 46%); hazard ratio (HR), .24 (.09 to .65); P = .005 and a lower CIR: 24% (95% CI, 21.5% to 57%) versus 78% (95% CI, 52% to 99%); HR, .18 (.05 to .50); P = .004. In multivariate analysis, a full CD3(+) TCC remained associated with a lower CIR (HR, .17 [.028 to .99]; P = .049). CD3(+) TCC has no impact on graft-versus-host disease and nonrelapse mortality in this study. In conclusion, here, full CD3(+) TCC was independently associated with a lower risk of relapse in adults receiving a dUCB TCF RIC allogeneic transplantation. This highlights the need to develop immunotherapy approaches allowing for early conversion to full chimerism after this type of transplantation.
SN - 1083-8791
SN - 1523-6536
ER -