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- Title
High percentage of CD34-positive cells in autologous AML peripheral blood stem cell products reflects inadequate in vivo purging and low chemotherapeutic toxicity in a subgroup of patients with poor clinical outcome.
- Authors
Feller, N; Schuurhuis, G J; van der Pol, M A; Westra, G; Weijers, G W D; van Stijn, A; Huijgens, P C; Ossenkoppele, G J
- Abstract
In this study, a high CD34% in autologous peripheral blood stem cell (PBSC) products from 71 AML patients was associated directly with a high relapse rate (P = 0.006) and inversely with disease-free survival (P = 0.003), irrespective whether patients were transplanted or not. The relapse rate at 12 months was 67% in a group with >0.8% CD34[SUP+] cells and 34% in a group with &les;0.8% CD34[SUP+] cells. Although the percentage of malignant CD34[SUP+] cells in the CD34[SUP+] compartment in the relapses of the first group was not high (median 8%), the total number of malignant cells as a percentage of WBC was about 13 times higher than for the patients remaining >12 months in remission. When all patients evaluable were taken together, this frequency of malignant cells correlated strongly with disease-free survival (P < 0.001). Both this massive mobilization of normal CD34[SUP+] cells and high frequency of malignant cells in the subgroup of patients with CD34 >0.8% and relapse within 12 months indicate an insufficient in vivo purging, as well as low chemotherapeutic bone marrow toxicity. This was con-firmed by an inverse correlation between hypoplasia period after the induction therapy and CD34% in PBSC products (P < 0.002). It is concluded that a subgroup of patients has been identified that might benefit from a more intensive chemotherapeutic treatment.
- Subjects
ACUTE myeloid leukemia; STEM cells; PATIENTS
- Publication
Leukemia (08876924), 2003, Vol 17, Issue 1, p68
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/sj.leu.2402781