title: Higher infused CD34+ cell dose and overall survival in patients undergoing in vivo T-cell depleted, but not t-cell repleted, allogeneic peripheral blood hematopoietic cell transplantation.
abstract: OBJECTIVE
  Understanding the effect of cellular graft composition on allogeneic hematopoietic cell transplantation (AHCT) outcomes is an area of great interest. The objective of the study was to analyze the correlation between transplant-related outcomes and administered CD34+, CD3+, CD4+ and CD8+ cell doses in patients who had undergone peripheral blood, AHCT and received either in vivo T-cell depleted or T-cell replete allografts.
  
  
  METHODS
  Comparison of consecutive patients who underwent peripheral blood AHCT in our institution between January 2003 and December 2009.
  
  
  METHODS
  The cohort of 149 patients was divided into two groups; non T-cell depleted (NTCD) (n=54) and T-cell depleted (TCD) (n=95). Study endpoints were overall survival (OS), progression free survival (PFS), engraftment kinetics (neutrophil and platelet recovery), incidence of acute graft versus host disease (acute GVHD), chronic GVHD, nonrelapse mortality (NRM) and disease relapse.
  
  
  RESULTS
  Multivariate analysis showed that higher infused CD34+ cell dose improved OS (relative risk 0.58, 95% CI 0.34-0.98, P=.04), PFS (relative risk 0.59, 95% CI 0.35-1.00, P=.05) and NRM (relative risk 0.49, 95% CI 0.24-0.99, P=.048) in the TCD group. By multivariate analysis, there was no difference in engraftment, grades II-IV acute GVHD, extensive chronic GVHD and relapse in the two groups relative to the infused cell doses. There was a trend towards improved OS (relative risk 0.54, 95% CI 0.29-1.01, P=.05) with higher CD3+ cell dose in the TCD group.
  
  
  CONCLUSIONS
  Our findings suggest that higher CD34+ cell dose imparts survival benefit only to in vivo TCD peripheral blood AHCT recipients.
authors.affiliation: Section of Hematology/Oncology, Department of Medicine, West Virginia University, USA. abesebastian@yahoo.com
authors.forename: Abraham Sebastian
authors.initials: AS
authors.lastname: Kanate
authors.forename: Michael
authors.initials: M
authors.lastname: Craig
authors.forename: Aaron
authors.initials: A
authors.lastname: Cumpston
authors.forename: Ayman
authors.initials: A
authors.lastname: Saad
authors.forename: Gerry
authors.initials: G
authors.lastname: Hobbs
authors.forename: Sonia
authors.initials: S
authors.lastname: Leadmon
authors.forename: Pamela
authors.initials: P
authors.lastname: Bunner
authors.forename: Kathy
authors.initials: K
authors.lastname: Watkins
authors.forename: Deirdre
authors.initials: D
authors.lastname: Bulian
authors.forename: Laura
authors.initials: L
authors.lastname: Gibson
authors.forename: Jame
authors.initials: J
authors.lastname: Abraham
authors.forename: Scott C
authors.initials: SC
authors.lastname: Remick
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hamadani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D007938:Leukemia / Q000628:therapy; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000706:statistics & numerical data; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D018952:Antigens, CD34