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- Title
Influence of the different CD34+ and CD34- cell subsets infused on clinical outcome after non-myeloablative allogeneic peripheral blood transplantation from human leucocyte antigen-identical sibling donors.
- Authors
Menendez, Pablo; Perez-Simon, Jose A.; Mateos, Maria V.; Caballero, Maria D.; Gonzalez, Marcos; San-Miguel, Jesus F.; Orfao, Alberto
- Abstract
Currently, no information is available regarding the influence of the different CD34[SUP+] cell subsets infused on the haematopoietic recovery, following non-myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT). We have explored, in a group of 13 patients receiving non-myeloablative allo-PBSCT from human leucocyte antigen-identical sibling donors, the influence of the total dose of CD34[SUP+] haematopoietic progenitor cells (HPC) infused, compared with that of the different CD34[SUP+] HPC and CD34[SUP-] leucocyte subsets in the leukapheresis samples, on both engraftment and clinical outcome. The overall numbers of total CD34[SUP+] HPC (P = 0.002) and myelomonocytic-committed CD34[SUP+] HPC infused (P = 0.0002) were strongly associated with neutrophil recovery (> 1 × 10[SUP9] neutrophils/l), the latter being the only independent parameter influencing neutrophil recovery. Regarding long-term engraftment, only the number of immature CD34[SUP+] HPC infused/kg correlated with the duration of hospitalization in the first 2 years after discharge (r = -0.75, P = 0.005). Both the overall amount of CD34[SUP+] HPC and the number of myelomonocytic CD34[SUP+] HPC infused showed a significant influence on the risk of graft-versus-host disease (GVHD). Thus, the overall probability of GVHD was 100% vs 25% for patients receiving ≥ 5 × 10[SUP6] CD34[SUP+] HPC or ≥ 3.5 × 10[SUP6] of myelomonocytic-committed CD34[SUP+] HPC vs lower doses (P = 0.013). None of the other CD34[SUP+] and CD34[SUP-] cell subsets analysed correlated with development of GVHD. In summary, our results suggest that in non-myeloablative allo-PBSCT, high numbers of CD34[SUP+] HPC, especially the myelomonocytic-committed CD34[SUP+] progenitors, lead to rapid neutrophil engraftment. However, they also strongly impair clinical outcome by increasing the incidence of GVHD.
- Subjects
TUMORS; FLOW cytometry; HOMOGRAFTS; GRAFT versus host disease
- Publication
British Journal of Haematology, 2002, Vol 119, Issue 1, p135
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1046/j.1365-2141.2002.03794.x