Allogeneic peripheral blood stem cell transplantation following CD34+ enrichment by density gradient separation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 25; no. 12; pp. 1223 - 1228
• Main Authors: VIJ, R, BROWN, R, SHENOY, S, HAUG, J. S, KAESBERG, D, ADKINS, D, GOODNOUGH, L. T, KHOURY, H, DIPERSIO, J
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.06.2000
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD34; Biological and medical sciences; Blood; Bone marrow; Bone marrow transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; CD3 antigen; CD34 antigen; Cell Separation - methods; Child; Child, Preschool; Cyclosporins; Cytokines; Density; Depletion; Graft-versus-host reaction; Hematologic Neoplasms - therapy; Hematopoietic Stem Cell Mobilization; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Histocompatibility antigen HLA; Humans; Inflammation; Interferon; Interleukin 8; Lymphocyte Depletion; Lymphocytes; Lymphocytes T; Medical sciences; Morbidity; Negative selection; Peripheral blood; Prophylaxis; Separation; Silica; Silicon dioxide; Stem cell transplantation; Stem cells; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; γ-Interferon; Human; Immunopathology; Acute; Stem cell; Selection; Cytokine; Related donor; Hematopoietic cell; Homograft; Graft versus host reaction; Malignant hemopathy; Cell subpopulation; Blood; Mobilization; Granulocyte colony stimulating factor; Treatment; Polypeptide; Complication; Graft; Density gradient; Gamma interferon
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1702427

GVHD is a significant cause of morbidity and mortality following allogeneic peripheral blood stem cell transplantation (AlloPBSC). CD34+ cell selection could reduce GVHD by negative selection of T cells. In an attempt to reduce the T cell content of alloPBSC we carried out a trial in which 11 patients with hematologic malignancies received alloPBSC from HLA-matched siblings following density gradient separation using an isotonic colloidal silica solution (BDS 60; Dendreon Corporation). Cyclosporine and methylprednisone were used for GVHD prophylaxis. The mean yield of CD34+ cells was 69 +/- 15.6% with a purity of 2.9 +/- 1.7%. The mean number of CD3+ cells infused was 1.0 +/- 1.2 x 107/kg, representing a 1.3 log depletion. A high risk of acute GVHD was observed: grade II-IV in 7/11 (64%) and grade III-IV GVHD in 5/11 (45%) patients. Nine of the 11 (82%) patients died with a median survival of 68 days. Cytokine expression in PBSC was compared pre and post processing. Interferon-gamma was detected only following density gradient separation while IL-8 expression increased 3- to 6-fold post processing. Therefore, processing with this device may augment production of pro-inflammatory cytokines. Bone Marrow Transplantation (2000) 25, 1223-1228.