HLA-identical stem cell transplantation: is there an optimal CD34 cell dose?
A review of the published literature, supplemented with a recent analysis of Fred Hutchinson 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-PBMC have been incorporated. The three primary findings are: (1) higher CD34 dose results in better neutrophil and platelet recovery in all settings; (2) high CD34 doses (>8 x 10(6)/kg) are associated with the development of more chronic GVHD when using related G-PBMC; (3) higher CD34 dose is correlated with improved survival after bone marrow transplantation, especially with unrelated donors. This is not seen when using G-PBMC. The data suggest that the CD34 content of the graft can have a significant impact on clinical outcome after allogeneic transplantation, but optimal dose is dependent on both donor type and stem cell source.
Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-390 Seattle, WA 98109, USA.
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D018952:Antigens, CD34 / Q000097:blood / Q000276:immunology*; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality
D018952:Antigens, CD34; D006680:HLA Antigens