Host T cells affect donor T cell engraftment and graft-versus-host disease after reduced-intensity hematopoietic stem cell transplantation

Biol Blood Marrow Transplant. 2007 Sep;13(9):1022-30. doi: 10.1016/j.bbmt.2007.05.008. Epub 2007 Jul 16.


Mixed chimerism in the T cell compartment (MCT) after reduced-intensity stem cell transplantation (RIST) may influence immune repopulation with alloreactive donor T cells. We examined effects of host T cell numbers on donor T cell engraftment and recovery and on acute graft-versus-host disease (aGVHD) in a relatively homogeneous patient population with respect to residual host T cells through quantified immune depletion prior to RIST and to donor T cells by setting the allograft T cell dose of 1x10(5) CD3+ cells/kg. In this setting, 2 patterns of early donor T cell engraftment could be distinguished by day +42: (1) early and complete donor chimerism in the T cell compartment (FDCT) and (2) persistent MCT. FDCT was associated with lower residual host CD8+ T cell counts prior to transplant and aGVHD. With persistent MCT, subsequent development of aGVHD could be predicted by the direction of change in T cell donor chimerism after donor lymphocyte infusion, and no aGVHD occurred until FDCT was established. MCT did not affect recovery of donor T cell counts. These observations suggest that the relative number and alloreactivity of donor and host T cells are more important than the absolute allograft T cell dose in determining donor engraftment and aGVHD after RIST.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / therapy
  • CD3 Complex / analysis
  • CD8-Positive T-Lymphocytes / cytology
  • Female
  • Graft Survival / immunology*
  • Graft vs Host Disease / immunology*
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Lymphocyte Count
  • Lymphocyte Transfusion / methods*
  • Male
  • Middle Aged
  • T-Lymphocytes / cytology
  • T-Lymphocytes / physiology*
  • Transplantation Chimera
  • Transplantation, Homologous


  • CD3 Complex