title: CD34 selected cells for the treatment of poor graft function after allogeneic stem cell transplantation.
abstract: Poor graft function (PGF) is characterized by pancytopenia and a hypoplastic marrow, with complete donor chimerism, usually without severe graft-versus-host disease (GVHD). We report 41 patients with PGF, treated with granulocyte colony-stimulating factor-mobilized CD34 selected cells, at a median interval from transplant of 140 days, without conditioning and without GVHD prophylaxis. Donors were HLA matched siblings (n = 12), unrelated donors (n = 18), or mismatched family members (n = 11). The median number of infused CD34(+) cells was 3.4 × 10(6)/kg. The rate of trilineage recovery was 75%: 83% for HLA matched siblings and 72% for unrelated and mismatched family members (P = .3). The cumulative incidence of acute grade II GVHD was 15%, and no patient developed de novo chronic GVHD. The actuarial 3-year survival is 63%: 76% and 25% for patients with or without trilineage recovery. These data confirm the role of CD34(+) selected cells from the same donor in the treatment of PGF and warrant the request for a second donation also when the donor is unrelated.
authors.affiliation: Divisione di Ematologia e UTMO, University of Milano Bicocca, Monza, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Stasia
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Ghiso
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Galaverna
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Raiola
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gualandi
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Luchetti
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pozzi
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Varaldo
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Lamparelli
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bregante
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Van Lint
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: di Grazia
authors.affiliation: Divisione di Ematologia e Trapianto di Midollo Osseo, IRCCS AOU San Martino-IST, Genova, Italy. Electronic address: apbacigalupo@yahoo.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006086:Graft vs Host Disease / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018952:Antigens, CD34
keywords: Allogeneic stem cell transplants; CD34; GVHD; Poor graft function; Rejection