Risk factors for acute graft-versus-host disease in patients undergoing transplantation with CD34+ selected blood cells from HLA-identical siblings.
A study on 315 patients undergoing transplantation with CD34+ selected blood cells from HLA-identical siblings was performed to determine risk factors for acute GVHD (aGVHD). Recipients of a dose of CD34+ cells (x 10(6)/kg) of 2 or less, more than 2 to 4, and more than 4 had a cumulative incidence of aGVHD grades I-IV of 21%, 35%, and 43%, respectively (log-rank P =.01); similarly, recipients of a dose of CD3+ cells (x 10(6)/kg) of 0.05 or less, more than 0.05 to 0.1, and more than 0.1 had a cumulative incidence of aGVHD grades I-IV of 18%, 35%, and 44%, respectively (log-rank P =.007). Using a Cox regression model, 4 independent factors for aGVHD I-IV were identified: increased CD34+ cell dose (P =.02), increased CD3+ cell dose (P =.02), female patients (P =.01), and higher patient age (> 42 years) (P =.007). This study shows, for the first time in T-cell-depleted transplantations, a positive correlation between the number of CD34+ cells and aGVHD and, also, that the number of CD3+ cells necessary to initiate aGVHD is lower than previously reported.
Urbano-Ispizua
Alvaro
A
Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain. aurbano@clinic.ub.es
Rozman
Ciril
C
Pimentel
Pedro
P
Solano
Carlos
C
de la Rubia
Javier
J
Brunet
Salut
S
Pérez-Oteyza
Jaime
J
Ferrá
Christelle
C
Zuazu
Javier
J
Caballero
Dolores
D
Bargay
Joan
J
Carvalhais
Alzira
A
Díez
Jose Luis
JL
Espigado
Ildefonso
I
Alegre
Adrián
A
Rovira
Montserrat
M
Campilho
Fernando
F
Odriozola
Jesús
J
Sanz
Miguel Angel
MA
Sierra
Jordi
J
García-Conde
Javier
J
Montserrat
Emili
E
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018952:Antigens, CD34 / Q000032:analysis; D001773:Blood Cells / Q000276:immunology / Q000637:transplantation; D017252:CD3 Complex / Q000032:analysis; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family; D012307:Risk Factors; D012737:Sex Factors; D014185:Transplantation, Isogeneic / Q000009:adverse effects / Q000379:methods
D018952:Antigens, CD34; D017252:CD3 Complex