Clinical applications of CD34+ cell-selected peripheral blood stem cells.
Peripheral blood stem cells (PBSC) are increasingly used for stem cell transplantation after high dose chemotherapy. CD34+ cell selection has also been done for use in autologous transplantation studies Bone marrow (BM) may contain tumor cells at the time of harvesting, and on re-infusion, these cells could contribute to a subsequent relapse. Similarly, tumor cell contamination of PBSC collections has been found in a number of studies. Therefore, purging contaminating tumor cells may prevent cases of relapse. As most tumor cell types do not express CD34 antigen, one of the most widespread applications of CD34+ cell selection is likely to be in tumor cell purging. Similarly, CD34+ cell selection has aided allogeneic transplantation studies. Acute graft-versus-host disease (aGVHD) is a major cause of morbidity and mortality in cases of allogeneic transplantation. As aGVHD is mediated by donor T cells, removal of T cells from the graft by CD34+ cell selection may ensure prophylaxis against aGVHD. Further, high-dose immunosuppression followed by CD34+ cell-selected stem cell rescue is theoretically reasonable as a therapeutic tool for patients with autoimmune disease resistant to conventional therapy. However, patients given T cell-depleted transplantation have an increased risk of opportunistic infection as well as malignancies related to immunosuppression; therefore, close monitoring is warranted. We describe here clinical applications of CD34+ cell-selected PBSC for a variety of diseases, with special emphasis on the efficacy as well as drawbacks of this novel technique.
Kawabata
Y
Y
Department of Internal Medicine III, Akita University School of Medicine, Akita, Japan.
Hirokawa
M
M
Komatsuda
A
A
Sawada
K
K
D018952:Antigens, CD34 / Q000276:immunology* / Q000627:therapeutic use*; D016465:Bone Marrow Purging / Q000379:methods*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000473:pathology / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014181:Transplantation Immunology / Q000502:physiology; D014182:Transplantation, Autologous / Q000379:methods; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
D018952:Antigens, CD34