Favorable Outcomes in Patients with High Donor-Derived T Cell Count after In Vivo T Cell–Depleted Reduced-Intensity Allogeneic Stem Cell Transplantation

Patients with hematologic malignancies were conditioned using a rabbit antithymocyte globulin–based reduced-intensity conditioning regimen for allogeneic stem cell transplantation. Donor-derived CD3+ cell count (ddCD3), a product of CD3+ cell chimerism and absolute CD3+ cell count, when <110/μL at 8 weeks post-stem cell transplantation predicted a high risk of sustained mixed chimerism and relapse. Alternatively, patients with a higher ddCD3 developed graft-versus-host disease more frequently, and when partially chimeric, had higher rates of conversion to full donor chimerism after withdrawal of immunosuppression. Early data from our small cohort of patients indicate that ddCD3 at 8 weeks may be used to guide decisions regarding withdrawal of immunosuppression and administration of donor lymphocyte infusion in partially T cell–depleted reduced-intensity regimens.