Allogeneic peripheral blood stem cell transplantation following CD34+ enrichment by density gradient separation.
GVHD is a significant cause of morbidity and mortality following allogeneic peripheral blood stem cell transplantation (AlloPBSC). CD34+ cell selection could reduce GVHD by negative selection of T cells. In an attempt to reduce the T cell content of alloPBSC we carried out a trial in which 11 patients with hematologic malignancies received alloPBSC from HLA-matched siblings following density gradient separation using an isotonic colloidal silica solution (BDS 60; Dendreon Corporation). Cyclosporine and methylprednisone were used for GVHD prophylaxis. The mean yield of CD34+ cells was 69 +/- 15.6% with a purity of 2.9 +/- 1.7%. The mean number of CD3+ cells infused was 1.0 +/- 1.2 x 107/kg, representing a 1.3 log depletion. A high risk of acute GVHD was observed: grade II-IV in 7/11 (64%) and grade III-IV GVHD in 5/11 (45%) patients. Nine of the 11 (82%) patients died with a median survival of 68 days. Cytokine expression in PBSC was compared pre and post processing. Interferon-gamma was detected only following density gradient separation while IL-8 expression increased 3- to 6-fold post processing. Therefore, processing with this device may augment production of pro-inflammatory cytokines. Bone Marrow Transplantation (2000) 25, 1223-1228.
Vij
R
R
Washington University School of Medicine, Divisions of Bone Marrow Transplantation and Stem Cell Biology, St Louis, MO 63110-1093, USA.
Brown
R
R
Shenoy
S
S
Haug
J S
JS
Kaesberg
D
D
Adkins
D
D
Goodnough
L T
LT
Khoury
H
H
DiPersio
J
J
D018952:Antigens, CD34; D002469:Cell Separation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D019337:Hematologic Neoplasms / Q000628:therapy*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008212:Lymphocyte Depletion; D014184:Transplantation, Homologous
D018952:Antigens, CD34