title: CD34(+)-selected stem cell boost without further conditioning for poor graft function after allogeneic stem cell transplantation in patients with hematological malignancies.
abstract: We retrospectively analyzed outcomes of a CD34(+)-selected stem cell boost (SCB) without prior conditioning in 32 patients (male/22; median age of 54 years; range, 20 to 69) with poor graft function, defined as neutrophils ≤1.5 x 10(9)/L, and/or platelets ≤30 x 10(9)/L, and/or hemoglobin ≤8.5 g/dL). The median interval between stem cell transplantation and SCB was 5 months (range, 2 to 228). The median number of CD34(+) and CD3(+) cells were 3.4 x 10(6)/kg (.96 to 8.30) and 9 x 10(3)/kg body weight (range, 2 to 70), respectively. Hematological improvement was observed in 81% of patients and noted after a median of 30 days (range, 14 to 120) after SCB. The recipients of related grafts responded faster than recipients of unrelated grafts (20 versus 30 days, P = .04). The cumulative incidence of acute (grade II to IV) and chronic graft-versus-host disease (GVHD) after SCB was 17% and 26%, respectively. Patients with acute GVHD received a higher median CD3(+) cell dose. The 2-year probability of overall survival was 45%. We suggest that SCB represents an effective approach to improve poor graft function post transplantation, but optimal timing of SCB administration, anti-infective, and GVHD prophylaxis needs further evaluation.
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Evgeny
authors: E
authors: Klyuchnikov
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Jean
authors: J
authors: El-Cheikh
authors: Institute for Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Andreas
authors: A
authors: Sputtek
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Michael
authors: M
authors: Lioznov
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Boris
authors: B
authors: Calmels
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Sabine
authors: S
authors: Furst
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Christian
authors: C
authors: Chabannon
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Roberto
authors: R
authors: Crocchiolo
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Claude
authors: C
authors: Lemarié
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Catherine
authors: C
authors: Faucher
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Ulrike
authors: U
authors: Bacher
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Haefaa
authors: H
authors: Alchalby
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Thomas
authors: T
authors: Stübig
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Christine
authors: C
authors: Wolschke
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Francis
authors: F
authors: Ayuk
authors: Institute for Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Marie-Luise
authors: ML
authors: Reckhaus
authors: Department for Stem Cell Transplantation, Institut Paoli Calmettes, Marseille, France.
authors: Didier
authors: D
authors: Blaise
authors: Department for Stem Cell Transplantation, University Cancer Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: n.kroeger@uke.de.
authors: Nicolaus
authors: N
authors: Kröger
mesh_terms: D000208:Acute Disease; D000328:Adult; D018952:Antigens, CD34 / Q000276:immunology*; D017252:CD3 Complex / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology / Q000276:immunology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D014184:Transplantation, Homologous
chemical_list: D018952:Antigens, CD34; D017252:CD3 Complex
keywords: Allogeneic hematopoietic stem cell transplantation (HSCT); CD34(+)-selected cells; Poor graft function; Stem cell boost