Impact of transplanted CD34+ cell dose in allogeneic unmanipulated peripheral blood stem cell transplantation.
The impact of the CD34+ cell dose on chronic graft-versus-host disease (cGVHD) and the clinical outcome was analyzed in 41 consecutive adult patients submitted to allogeneic peripheral blood stem cell transplantation from HLA-identical siblings. The patients were classified into 'low' or 'high' CD34+ cell dose groups based on whether they received less or more than a median CD34+ cell dose of 10.5 x 10(6)/kg, respectively. There was a significant difference in the incidence of extensive cGVHD (low vs high group, 25.0 vs 66.7%, P=0.021) and relapse (47.6 vs 20.0%, P=0.049) between the two groups. With a median follow-up of 335 days, the 3-year survival estimate for the whole population was 47.9%, while that for the low and high groups was 29.9 and 67.8%, respectively (P=0.0434). An inverse relation was noted between the relapse rate and the incidence of extensive cGVHD (P=0.043). It would appear reasonable that the optimal dose of CD34+ cells should be determined based on the disease status or aggressiveness of the malignant cells in each patient. Yet, in the case of patients with a high risk of relapse, transplantation with a CD34+ cell dose of >10.5 x 10(6)/kg would seem to be acceptable to minimize the risk of relapse.
Sohn
S K
SK
Department of Hematology/Oncology, Kyungpook National University Hospital, Taegu, South Korea.
Kim
J G
JG
Kim
D H
DH
Lee
N Y
NY
Suh
J S
JS
Lee
K B
KB
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D015703:Antigens, CD / Q000097:blood; D018952:Antigens, CD34 / Q000097:blood*; D006086:Graft vs Host Disease / Q000453:epidemiology*; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D019520:Living Donors; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D012189:Retrospective Studies; D035781:Siblings; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous / Q000009:adverse effects*; D016896:Treatment Outcome
D015703:Antigens, CD; D018952:Antigens, CD34