Bone marrow transplantation: how important is CD34 cell dose in HLA-identical stem cell transplantation?
A recent analysis of Fred Hutchinson Cancer Research Center data has been undertaken to investigate the association of infused CD34 cell dose with various clinical outcomes after HLA-identical transplantation. Separate assessments for unrelated vs related donors and the use of bone marrow or mobilized G-CSF stimulated peripheral blood mononuclear cells (G-PBMC) have been incorporated. The three primary findings are: (1) Higher CD34 dose results in better neutrophil and platelet recovery in all settings. (2) Higher CD34 doses (8 x 10(6)/kg) are associated with the development of more chronic graft-versus-host disease when using related G-PBMC. (3) Higher CD34 dose is correlated with improved survival after unrelated donor bone marrow transplantation. These data suggest that the CD34 content of a graft can have a significant impact on clinical outcome after allogeneic transplantation, but defining an optimal dose is dependent on both the type of donor and the stem cell source.
Heimfeld
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Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
D018952:Antigens, CD34 / Q000502:physiology*; D016026:Bone Marrow Transplantation; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans
D018952:Antigens, CD34; D006680:HLA Antigens