title: Impact of CD34+ cell dose in children who receive unrelated PBSCT with in vivo T-cell depletion for hematologic malignancies.
abstract: PBSCs are increasingly being chosen as the mode of donation among unrelated donors. Pediatric patients, in particular, may receive very high CD34(+) and CD3(+) doses during unrelated PBSCT. In this work, we analyzed survival and GVHD outcomes in a cohort of 81 children who received unrelated PBSCT with uniform antithymocyte globulin (ATG)-based in vivo T-cell depletion for treatment of hematologic malignancy, with emphasis on the impact of cell dose on transplant outcomes. EFS was 61.5±5.6%, with higher CD34(+) dose (>10.0 × 10(6)/kg) and lower patient risk status predicting improved survival in multivariate study. Cumulative incidence of relapse was 30.2±5.2%; a low CD34(+) dose was the only significant factor for relapse. Neither CD34(+) nor CD3(+) dose was a significant determinant of acute or chronic GVHD. Importance of CD34(+) dose was reaffirmed in a subcohort of younger patients who received greater median cell doses than the overall cohort. In summary, for children who received unrelated PBSCT with ATG-based T-cell depletion for treatment of hematologic malignancy, the CD34(+) dose was the most important factor for relapse and EFS, and neither the CD34(+) nor the CD3(+) dose influenced incidence of acute or chronic GVHD.
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: S-K
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: P-S
authors.initials: PS
authors.lastname: Jang
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: N-G
authors.initials: NG
authors.lastname: Chung
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: D-C
authors.initials: DC
authors.lastname: Jeong
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: B
authors.initials: B
authors.lastname: Cho
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: H-K
authors.initials: HK
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D064591:Allografts; D018952:Antigens, CD34; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000378:metabolism / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007223:Infant; D008212:Lymphocyte Depletion; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D015996:Survival Rate
chemical_list: D018952:Antigens, CD34; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents