title: Hematopoietic recovery in cancer patients after transplantation of autologous peripheral blood CD34+ cells or unmanipulated peripheral blood stem and progenitor cells.
abstract: BACKGROUND
  A study of CD34+ cell selection and transplantation was carried out with particular emphasis on characteristics of short- and long-term hematopoietic recovery.
  
  
  METHODS
  Peripheral blood stem and progenitor cells (PBPCs) were collected from 32 patients, and 17 CD34+ cell-selection procedures were carried out in 15 of the 32. One patient in whom two procedures failed to provide 1 x 10(6) CD34+ cells per kg was excluded from further analysis. After conditioning, patients received CD34+ cells (n = 10, CD34 group) or unmanipulated (n = 17, PBPC group) PBPCs containing equivalent amounts of CD34+ cells or progenitors.
  
  
  RESULTS
  The yield of CD34+ cells was 53 percent (18-100) with a purity of 63 percent (49-82). The CD34+ fraction contained 66 percent of colony-forming units--granulocyte-macrophage (CFU-GM) and 58 percent of CFU of mixed lineages, but only 33 percent of burst-forming units-erythroid (BFU-E) (p < 0.05). Early recovery of neutrophils and reticulocytes was identical in the two groups, although a slight delay in platelet recovery may be seen with CD34+ cell selection. Late hematopoietic reconstitution, up to 1.5 years after transplant, was also similar. The two groups were thus combined for analyses of dose effects. A dose of 40 x 10(4) CFU-GM per kg ensured recovery of neutrophils to a level of 1 x 10(9) per L within 11 days, 15 x 10(4) CFU of mixed lineages per kg was associated with platelet independence within 11 days, and 100 x 10(4) BFU-E per kg predicted red cell independence within 13 days. However, a continuous effect of cell dose well beyond these thresholds was apparent, at least for neutrophil recovery.
  
  
  CONCLUSIONS
  CD34+ cell selection, despite lower efficiency in collecting BFU-E, provides a suitable graft with hematopoietic capacity comparable to that of unmanipulated PBPCs. In both groups, all patients will eventually show hematopoietic recovery of all three lineages with 1 x 10(6) CD34+ cells per kg or 5 x 10(4) CFU-GM per kg, but a dose of 5 x 10(6) CD34+ cells or 40 x 10(4) CFU-GM per kg is critical to ensure rapid recovery.
authors.affiliation: Department of Medicine, University of Liège, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Beguin
authors.forename: E
authors.initials: E
authors.lastname: Baudoux
authors.forename: B
authors.initials: B
authors.lastname: Sautois
authors.forename: V
authors.initials: V
authors.lastname: Fraipont
authors.forename: N
authors.initials: N
authors.lastname: Schaaf-Lafontaine
authors.forename: M
authors.initials: M
authors.lastname: Pereira
authors.forename: J M
authors.initials: JM
authors.lastname: Paulus
authors.forename: D
authors.initials: D
authors.lastname: Sondag
authors.forename: G
authors.initials: G
authors.lastname: Fillet
mesh_terms: D018952:Antigens, CD34; D002454:Cell Differentiation; D002455:Cell Division; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000473:pathology*; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34