title: Infused CD34+ cell dose predicts long-term survival in acute myelogenous leukemia patients who received allogeneic bone marrow transplantation from matched sibling donors in first complete remission.
abstract: Allogeneic stem cell transplantation (ASCT) has improved the outcome of acute myelogenous leukemia (AML). To further improve the treatment outcome of ASCT in AML, finding a modifiable prognostic factor is mandatory. We evaluated the effect of CD34(+) cell dose on survival in allogeneic bone marrow transplantation (BMT) from HLA-matched sibling donors for AML patients in first complete remission (CR1). The 99 patients included in our analysis were classified into high CD34(+) cell dose group (CD34(+) cells > or = 2.5 x 10(6)/kg) and low CD34(+) cell dose group (CD34(+) cells < 2.5 x 10(6)/kg). The high CD34(+) cell dose patients had better overall survival (5-year overall survival rate, 75% +/- 6% vs 52% +/- 9%; P = .01) and leukemia-free survival (5-year leukemia-free survival rate, 70% +/- 6% vs 44% +/- 9%; P = .04). CD34(+) cell dose was the only independent prognostic factor in overall survival and leukemia-free survival. The high CD34(+) cell dose group had a lower relapse incidence with a borderline statistical significance (5-year relapse rate, 27% +/- 6% vs 50% +/- 10%; P = .09). There were no differences in the engraftment of neutrophil and platelet, grade II-IV acute graft-versus-host disease (GVHD), extensive-stage chronic GVHD, and transplant-related mortality between the high and low CD34(+) cell dose groups. We confirmed that high CD34(+) cell dose favorably affects the outcomes in allogeneic BMT for AML. The effort to attain a high CD34(+) cell dose should be pursued during bone marrow harvest in allogeneic BMT for AML in CR1.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Mark H
authors.initials: MH
authors.lastname: Lee
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Yoo Hong
authors.initials: YH
authors.lastname: Min
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
authors.forename: Keon Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Kang
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Seong-Jun
authors.initials: SJ
authors.lastname: Choi
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis*; D001854:Bone Marrow Cells / Q000166:cytology*; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D035781:Siblings; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34