title: Extensive chronic GVHD is associated with donor blood CD34+ cell count after G-CSF mobilization in non-myeloablative allogeneic PBSC transplantation.
abstract: The correlation between the incidence of GVHD and the number of infused CD34(+) cells remains controversial for PBSC transplantation after a reduced-intensity-conditioning (RIC) regimen. We evaluated 99 patients transplanted with an HLA-identical sibling after the same RIC (2-Gy-TBI/fludarabine). Donor and recipient characteristics, donor's blood G-CSF-mobilized CD34(+) cell count, and number of infused CD34(+) and CD3(+) cells were analyzed as risk factors for acute and chronic GVHD There was a trend for an increased incidence of extensive chronic GVHD in the quartile of patients receiving more than 10 × 10(6) CD34(+) cells/kg (P = 0.05). Interestingly, the number of donor's blood CD34(+) cells at day 5 of G-CSF mobilization was closely associated with the incidence of extensive chronic GVHD, that is, 48% (95% CI: 28-68) at 24-months in the quartile of patients whose donors had the highest CD34(+) cell counts versus 24.3% (95% CI: 14-34) in the other patients (P = 0.007). In multivariate analysis, the only factor correlating with extensive chronic GVHD (cGVHD) was the donor's blood CD34(+) cell count after G-CSF (HR 2.49; 95% CI: 1.16-5.35, P = 0.019). This study shows that the incidence of cGVHD is more strongly associated with the donor's ability to mobilize CD34(+) cells than with the number of infused CD34(+) cells.
authors.affiliation: Service de Greffe de Moelle, Unité Adolescents et Jeunes Adultes (AJA), Paris, France. nathalie.dhedin@sls.aphp.fr
authors.forename: N
authors.initials: N
authors.lastname: Dhédin
authors.forename: T
authors.initials: T
authors.lastname: Prébet
authors.forename: R Peffault
authors.initials: RP
authors.lastname: De Latour
authors.forename: S
authors.initials: S
authors.lastname: Katsahian
authors.forename: M
authors.initials: M
authors.lastname: Kuentz
authors.forename: N
authors.initials: N
authors.lastname: Piard
authors.forename: D
authors.initials: D
authors.lastname: Réa
authors.forename: F
authors.initials: F
authors.lastname: Norol
authors.forename: J P
authors.initials: JP
authors.lastname: Jouet
authors.forename: J A
authors.initials: JA
authors.lastname: Ribeil
authors.forename: R
authors.initials: R
authors.lastname: Tabrizi
authors.forename: B
authors.initials: B
authors.lastname: Rio
authors.forename: B
authors.initials: B
authors.lastname: Lioure
authors.forename: P
authors.initials: P
authors.lastname: Tiberghien
authors.forename: J H
authors.initials: JH
authors.lastname: Bourhis
authors.forename: A
authors.initials: A
authors.lastname: Sirvent
authors.forename: P
authors.initials: P
authors.lastname: Bordigoni
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.forename: J P
authors.initials: JP
authors.lastname: Vernant
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000097:blood / Q000276:immunology*; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000097:blood / Q000276:immunology*; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor