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CD34+ Cell Dose

Influence of CD34+ marrow cell dose on outcome of HLA-identical sibling allogeneic bone marrow transplants in patients with chronic myeloid leukaemia

Bone Marrow Transplantation volume 27, pages 575–580 (2001)Cite this article

Abstract

In order to study the influence of bone marrow CD34+ cell dose on the outcome of allogeneic bone marrow transplantation (BMT), we analysed the results of BMT from HLA-identical siblings donors in 50 patients with chronic myeloid leukaemia (CML). The median numbers of nucleated cells (NC) and CD34+ cells infused were 2.18 × 108/kg (0.05–4.14 × 108/kg) and 3.12 × 106/kg (0.35–8.52 × 106/kg), respectively. All patients engrafted. In univariate analysis, there was no correlation between the number of CD34+ cells infused and the time to neutrophil recovery (P = 0.17). The Kaplan–Meier estimate of grade II–IV acute graft-versus-host disease (GVHD) at day 100 was 53 ± 14% and 2-year survival was 46 ± 15%. A number of CD34+ cells infused greater than the median was the main factor increasing survival (P = 0.0006) and decreasing 100 day transplant-related mortality (P = 0.009). Patient-, disease- and transplant-related characteristics were not statistically different among patients receiving more or less than the median number of CD34+ cells. The rate of infectious deaths was significantly higher in patients receiving less than 3.12 × 106 CD34/kg (48% vs 16%, P = 0.01). In a multivariable analysis, two factors associated with increased risk of death were advanced disease status at transplant (HR: 2.5 (95% CI: 1.09–5.75), P = 0.03) and a lower number of marrow CD34+ cells infused/kg (HR: 4.55 (95% CI: 1.87–10.90), P = 0.0008). Bone Marrow Transplantation (2001) 27, 575–580.

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References

  1. Bensinger WI, Longin K, Appelbaum F et al. Peripheral blood stem cells (PBSCs) collected after recombinant granulocyte colony stimulating factor (rhG-CSF): an analysis of factors correlating with the tempo of engraftment after transplantation Br J Haematol 1994 87: 825–831

    Article  CAS  PubMed  Google Scholar 

  2. Bensinger W, Appelbaum F, Rowley S et al. Factors that influence collection and engraftment of autologous peripheral blood stem cells J Clin Oncol 1995 13: 2547–2555

    Article  CAS  PubMed  Google Scholar 

  3. To LB, Roberts MM, Haylock DN et al. Comparison of haematological recovery times and supportive care requirements of autologous peripheral blood stem cell transplants, autologous bone marrow transplants and allogeneic bone marrow transplants Bone Marrow Transplant 1992 9: 277–284

    CAS  PubMed  Google Scholar 

  4. Weaver C, Hazelton B, Birch R et al. An analysis of engraftment kinetics as a function of the CD34 content of peripheral blood progenitor cell collections in 692 patients after the administration of myeloablative chemotherapy Blood 1995 86: 3961–3969

    CAS  PubMed  Google Scholar 

  5. Korbling M, Huh Yo, Durett A et al. Allogeneic blood stem cell transplantation. Peripheralisation and yield of donor-derived primitive haematopoietic progenitor cells (CD34+, Th-dim) and lymphoid subsets and possible predictors of engraftment and graft-versus-host disease Blood 1995 86: 2842–2848

    CAS  PubMed  Google Scholar 

  6. Bahceci E, Rbad E, Leitman S et al. CD34+ cell dose predicts relapse and survival after T-cell-depleted HLA identical haematopoietic stem cell transplantation (HSCT) for haematologic malignancies Br J Haematol 2000 108: 408–414

    Article  CAS  PubMed  Google Scholar 

  7. Mavroudis D, Read E, Cottler-Fox M et al. CD34+ cell dose predicts survival, post transplant morbidity and rate of hematologic recovery after allogeneic marrow transplants for hematologic malignancies Blood 1996 88: 3223–3229

    CAS  PubMed  Google Scholar 

  8. Glucksberg H, Storb R, Fefer A et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors Transplantation 1974 18: 295–304

    Article  CAS  PubMed  Google Scholar 

  9. Shulman HM, Sullivan KM, Weiden PL et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients Am J Med 1980 69: 204–217

    Article  CAS  PubMed  Google Scholar 

  10. Gratwohl A, Hermans J, Goldman JM et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation Lancet 1998 352: 1087–1091

    Article  CAS  PubMed  Google Scholar 

  11. Atkinson K, Norrie S, Chan P et al. Lack of correlation between nucleated bone marrow cell dose, marrow CFU-GM dose or marrow CFU-E and the rate of HLA-identical sibling marrow engraftment Br J Haematol 1985 60: 245–251

    Article  CAS  PubMed  Google Scholar 

  12. Bacigalupo A, Piaggio G, Podesta M et al. Influence of marrow CFU-GM content on engraftment and survival after allogeneic bone marrow transplantation Bone Marrow Transplant 1995 15: 221–226

    CAS  PubMed  Google Scholar 

  13. Sierra J, Storer B, Hansen JA et al. Transplantation of marrow cells from unrelated donors for treatment of high-risk acute leukemia: the effect of leukemic burden, donor matching and marrow cell dose Blood 1997 89: 4226–4235

    CAS  PubMed  Google Scholar 

  14. Siena S, Schiavo R, Pedrazzoli P, Carlo-Stella C . Therapeutic relevance of CD34+ cell dose in blood cell transplantation for cancer therapy J Clin Oncol 2000 18: 1360–1377

    Article  CAS  PubMed  Google Scholar 

  15. Pavletic ZS, Bishop MR, Tarantolo SR . Haematopoietic recovery after allogeneic blood stem cell transplantation compared with bone marrow transplantation in patients with hematologic malignancies J Clin Oncol 1997 15: 1608–1616

    Article  CAS  PubMed  Google Scholar 

  16. Brecher ME, Sims L, Schmits J et al. North American multicenter study on flow cytometric enumeration of CD34+ hematopoïetic stem cells J Hematother 1996 5: 227–236

    Article  CAS  PubMed  Google Scholar 

  17. Sutherland DR, Anderson L, Keeney M et al. The ISHAGE guidelines for CD34+ cell determination by flow cytometry J Hematother 1996 5: 213–226

    Article  CAS  PubMed  Google Scholar 

  18. Arnold R, Schmeiser T, Heit W et al. Haematopoietic reconstitution after bone marrow transplantation Exp Hematol 1986 14: 271–277

    CAS  PubMed  Google Scholar 

  19. Vaziri H, Dragowsca W, Allsopp RC et al. Evidence for a mitotic clock in human haematopoietic stem cells: loss of telomeric DNA with age Proc Natl Acad Sci USA 1994 91: 9857–9860

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Martin PJ, Akatsnka Y, Hahue M, Sale G . Involvement of donor T-cell cytotoxic effector mechanisms in preventing allogeneic marrow graft rejection Blood 1998 92: 2177–2181

    CAS  PubMed  Google Scholar 

  21. Rocha V, Carmagnat M V, Chevret S et al. Influence of bone marrow graft lymphocyte subset on the outcome of HLA identical sibling transplants Blood 1999 94: 386b (Abstr.)

    Google Scholar 

  22. Storek J, Espino G, Dawson MA et al. Low-B cell and monocyte counts on day 80 are associated with high infection rates between days 100 and 365 after allogeneic marrow transplantation Blood 2000 96: 3290–3293

    CAS  PubMed  Google Scholar 

  23. Przepiorka D, Smith T, Folloder J et al. Risk factors for acute graft-versus-host disease after allogeneic blood cell transplantation Blood 1999 94: 1465–1470

    CAS  PubMed  Google Scholar 

  24. Blaise D, Kuentz M, Fortanier C et al. Randomized trial of bone marrow versus lenograstim-primed blood cell allogeneic transplantation in patients with early-stage leukaemia: a report from the Société Française de Greffe de Moelle J Clin Oncol 2000 18: 537–546

    Article  CAS  PubMed  Google Scholar 

  25. Champlin RE, Schmitz N, Horowitz M et al. Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation Blood 2000 95: 3702–3709

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Laboratory of Cellular Therapy, Saint Louis Hospital, Paris, France

    R Morariu-Zamfir & L Dal Cortivo

  2. Stem cell Transplant Unit, Saint Louis Hospital, Paris, France

    V Rocha, A Devergie, G Socié, P Ribaud, H Esperou, N Parquet, P Guardiola, H Bittencourt, F Garnier, R Traineau, JP Marolleau & E Gluckman

  3. Biostatistics Department, Saint Louis Hospital, Paris, France

    V Rocha & S Chevret

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  1. R Morariu-Zamfir
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Morariu-Zamfir, R., Rocha, V., Devergie, A. et al. Influence of CD34+ marrow cell dose on outcome of HLA-identical sibling allogeneic bone marrow transplants in patients with chronic myeloid leukaemia. Bone Marrow Transplant 27, 575–580 (2001). https://doi.org/10.1038/sj.bmt.1702852

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