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Waller EK, Logan BR, Harris WAC, Devine SM, Porter DL, Mineishi S, McCarty JM, Gonzalez CE, Spitzer TR, Krijanovski OI, Linenberger ML, Woolfrey A, Howard A, Wu J, Confer DL, Anasetti C. Improved survival after transplantation of more donor plasmacytoid dendritic or naïve T cells from unrelated-donor marrow grafts: results from BMTCTN 0201. J Clin Oncol 2014; 32:2365-72. [PMID: 24982459 DOI: 10.1200/jco.2013.54.4577] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To characterize relationships between specific immune cell subsets in bone marrow (BM) or granulocyte colony-stimulating factor-mobilized peripheral blood (PB) stem cells collected from unrelated donors and clinical outcomes of patients undergoing transplantation in BMTCTN 0201. PATIENTS AND METHODS Fresh aliquots of 161 BM and 147 PB stem-cell allografts from North American donors randomly assigned to donate BM or PB stem cells and numbers of transplanted cells were correlated with overall survival (OS), relapse, and graft-versus-host disease (GvHD). RESULTS Patients with evaluable grafts were similar to all BMTCTN 0201 patients. The numbers of plasmacytoid dendritic cells (pDCs) and naïve T cells (Tns) in BM allografts were independently associated with OS in multivariable analyses including recipient and donor characteristics, such as human leukocyte antigen mismatch, age, and use of antithymocyte globulin. BM recipients of > median number of pDCs, naïve CD8(+) T cells (CD8Tns), or naïve CD4(+) T cells (CD4Tns) had better 3-year OS (pDCs, 56% v 35%; P = .025; CD8Tns, 56% v 37%; P = .012; CD4Tns, 55% v 37%; P = .009). Transplantation of more BM Tns was associated with less grade 3 to 4 acute GvHD but similar rates of relapse. Transplantation of more BM pDCs was associated with fewer deaths resulting from GvHD or from graft rejection. Analysis of PB grafts did not identify a donor cell subset significantly associated with OS, relapse, or GvHD. CONCLUSION Donor immune cells in BM but not PB stem-cell grafts were associated with survival after unrelated-donor allogeneic hematopoietic stem-cell transplantation. The biologic activity of donor immune cells in allogeneic transplantation varied between graft sources. Donor grafts with more BM-derived Tns and pDCs favorably regulated post-transplantation immunity in allogeneic hematopoietic stem-cell transplantation.
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Affiliation(s)
- Edmund K Waller
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
| | - Brent R Logan
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Wayne A C Harris
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Steven M Devine
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - David L Porter
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Shin Mineishi
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - John M McCarty
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Corina E Gonzalez
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Thomas R Spitzer
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Oleg I Krijanovski
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Michael L Linenberger
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Ann Woolfrey
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Alan Howard
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Juan Wu
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Dennis L Confer
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Claudio Anasetti
- Edmund K. Waller and Wayne A.C. Harris, Emory University, Atlanta, GA; Brent R. Logan, Medical College of Wisconsin, Milwaukee, WI; Steven M. Devine, Ohio State University, Columbus, OH; David L. Porter, University of Pennsylvania, Philadelphia, PA; Shin Mineishi, University of Alabama at Birmingham, Birmingham, AL; John M. McCarty, Medical College of Virginia, Richmond, VA; Corina E. Gonzalez, Georgetown University Hospital, Washington, DC; Thomas R. Spitzer, Massachusetts General Hospital, Boston, MA; Oleg I. Krijanovski, Sutter East Bay Medical Foundation, Berkeley, CA; Michael L. Linenberger and Ann Woolfrey, Fred Hutchinson Cancer Research Center, Seattle, WA; Alan Howard and Dennis L. Confer, National Marrow Donor Program, Minneapolis, MN; Juan Wu, EMMES Corporation, Rockville, MD; and Claudio Anasetti, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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