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.
Heimfeld
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Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D5-390 Seattle, WA 98109, USA.
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