Table 1.

Overview of the impact of CD4 levels on HCT outcomes in children and adults

ReferencePlatformAdult/pediatricOutcomeNRM by CD4+No. of patientsType of study
Admiraal et al6  BM, PBSC, CB Pediatric, young adult Model-based dosing is associated with 90% CD4+ > 50 prior to day +100 and lower NRM in patients receiving ATG >50: 5-y TRM 8%
<50: 5-y TRM 34% 
214, multicenter Retrospective, prospective 
Lakkaraja et al39  Ex vivo TCD Pediatric, young adult >50 CD4+ before day +100 improves TRM >50: 5-y NRM 4%
<50: 5-y NRM 31% 
180, single center Retrospective 
Barriga et al40  BM, PBSC, CB Pediatric >50 CD4+ before day +100 improves TRM >50: 2-y NRM 2.7%
<50: 2-y NRM 22.2% 
101, single center Prospective 
Huang et al13  PBSC (haplo-identical and HLA matched) Adult >50 CD4+ before day +100 associated with lower risk for EBV and CMV reactivation NA 122, single center Retrospective 
Troullioud Lucas et al21  BM, PBSC, ex vivo TCD, CB Pediatric, young adult >50 CD4+ before day +100 improves outcomes
>25 CD19+ before day +100 reduces NRM 
NA 503, multicenter Retrospective 
Admiraal et al5  BM, CB Pediatric >50 CD4+ before day +100 improves TRM >50: 2-y TRM 7%
<50: 2-y TRM 43% 
58, single center Prospective 
Lakkaraja et al8  Ex vivo TCD Adult/pediatric >50 CD4+ before day +100 improves NRM >50: 5-y NRM 5%
<50: 5-y NRM 36% 
554, single center Retrospective 
De Koning et al41  BM, PBSC, in vitro TCD, CB Pediatric >50 CD4+ before day +100 improves OS and NRM after moderate to severe aGVHD In patients with grade 3-4 aGVHD
>50: 2-y NRM 30%
<50: 2-y NRM 80% 
591, multicenter Retrospective 
Van Roessel et al42  BM, PBSC, ex vivo TCD, CB Pediatric, young adult >50 CD4+ before day +100 is associated with improved survival >50: 5-y NRM 3.2%
<50: 5-y NRM 28.8% 
315, single center Retrospective 
Admiraal et al43  BM, PBSC, CB Pediatric >50 CD4+ T cells associated with fewer viral reactivations NA 273, single center Retrospective 
ReferencePlatformAdult/pediatricOutcomeNRM by CD4+No. of patientsType of study
Admiraal et al6  BM, PBSC, CB Pediatric, young adult Model-based dosing is associated with 90% CD4+ > 50 prior to day +100 and lower NRM in patients receiving ATG >50: 5-y TRM 8%
<50: 5-y TRM 34% 
214, multicenter Retrospective, prospective 
Lakkaraja et al39  Ex vivo TCD Pediatric, young adult >50 CD4+ before day +100 improves TRM >50: 5-y NRM 4%
<50: 5-y NRM 31% 
180, single center Retrospective 
Barriga et al40  BM, PBSC, CB Pediatric >50 CD4+ before day +100 improves TRM >50: 2-y NRM 2.7%
<50: 2-y NRM 22.2% 
101, single center Prospective 
Huang et al13  PBSC (haplo-identical and HLA matched) Adult >50 CD4+ before day +100 associated with lower risk for EBV and CMV reactivation NA 122, single center Retrospective 
Troullioud Lucas et al21  BM, PBSC, ex vivo TCD, CB Pediatric, young adult >50 CD4+ before day +100 improves outcomes
>25 CD19+ before day +100 reduces NRM 
NA 503, multicenter Retrospective 
Admiraal et al5  BM, CB Pediatric >50 CD4+ before day +100 improves TRM >50: 2-y TRM 7%
<50: 2-y TRM 43% 
58, single center Prospective 
Lakkaraja et al8  Ex vivo TCD Adult/pediatric >50 CD4+ before day +100 improves NRM >50: 5-y NRM 5%
<50: 5-y NRM 36% 
554, single center Retrospective 
De Koning et al41  BM, PBSC, in vitro TCD, CB Pediatric >50 CD4+ before day +100 improves OS and NRM after moderate to severe aGVHD In patients with grade 3-4 aGVHD
>50: 2-y NRM 30%
<50: 2-y NRM 80% 
591, multicenter Retrospective 
Van Roessel et al42  BM, PBSC, ex vivo TCD, CB Pediatric, young adult >50 CD4+ before day +100 is associated with improved survival >50: 5-y NRM 3.2%
<50: 5-y NRM 28.8% 
315, single center Retrospective 
Admiraal et al43  BM, PBSC, CB Pediatric >50 CD4+ T cells associated with fewer viral reactivations NA 273, single center Retrospective 

CB, cord blood; CMV, cytomegalovirus; EBV, Epstein-Barr virus; NA, not available; PBSC, peripheral blood mononuclear cell; TRM, transplant-related mortality.

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