Impact of the CD4:CD8 ratio in bone marrow on stem cell mobilization and engraftment in autologous stem cell transplant patients.

Abstract

Bone marrow (BM) damage after previous chemotherapy, such as that involving alkylating agents, and radiation therapy alone cannot explain poor hematopoietic progenitor cell mobilization. We examined the T lymphocytes of BM in 67 autologous peripheral blood stem cell transplant (auto-PBSCT) patients with non-Hodgkin lymphoma (NHL) or multiple myeloma (MM) to establish whether the cellular phenotype predicts mobilization and engraftment between January 2000 and January 2020 at the Japanese Red Cross Society Wakayama Medical Center. The total number of mobilized CD34+ cells was <2 × 106 /kg in 30 patients (group A) and ≥2 × 106 /kg in 37 (group B). The median absolute number of CD3+CD4+ cells was lower in group A than in group B (P = .013), and the median absolute number of CD3+CD8+ cells was higher in group A than in group B (P = .016). A low CD4:CD8 ratio was observed in all patients in group A, whereas all patients in group B showed a normal CD4:CD8 ratio (P < .001). A strong correlation was found between the CD4:CD8 ratio and median total CD34+ cells yield (r = .723, P < .001). The present results showed that a lower CD4:CD8 ratio correlated with later neutrophil and platelet engraftment (r = .662, P = .007 and r = .571, P = .008, respectively). The present results indicate that the CD4:CD8 ratio in BM contributes to the prediction of mobilization and engraftment in auto-PBSCT patients.