The number of infused CD34+ cells does not influence the incidence of GVHD or the outcome of allogeneic PBSC transplantation, using reduced-intensity conditioning and antithymocyte globulin

• Published in: Bone marrow transplantation (Basingstoke) Vol. 45; no. 7; pp. 1189 - 1196
• Main Authors: Tsirigotis, P, Shapira, M Y, Or, R, Bitan, M, Samuel, S, Gesundheit, B, Ackerstein, A, Abdul-Hai, A, Slavin, S, Resnick, I B
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.07.2010; Nature Publishing Group
• Subjects: Adolescent; Adult; Age Factors; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD34; Antilymphocyte serum; Antilymphocyte Serum - therapeutic use; Antithymocyte globulin; Biological and medical sciences; Bone marrow; Bone marrow transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; CD34 antigen; Cell Biology; Cell Count; Composition; Dosage; Female; Globulins; Graft versus host reaction; Graft vs Host Disease; Health aspects; Health risks; Hematology; Hematopoietic stem cells; Humans; Impact analysis; Incidence; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Neoplasms; original-article; Peripheral Blood Stem Cell Transplantation - methods; Prevention; Public Health; Risk; Risk factors; Sex Factors; Statistical analysis; Stem cell transplantation; Stem Cells; Subgroups; Thymocytes; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation Conditioning - methods; Transplantation, Homologous; Treatment Outcome; Young Adult; Israel; reduced-intensity conditioning; non-myeloablative conditioning; CD34+ cell dose; graft-versus-host disease; Immunopathology; Graft versus host disease; Prognosis; Hematology; Stem cell; Hematopoietic cell; Homograft; Non myeloablative treatment; Epidemiology; Cell subpopulation; Incidence; CD34 + cell dose; Treatment; Allogeneic hematopoietic stem cell transplantation; Immunotherapy; Graft; Dose; Antithymocyte globulin
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2009.331

The influence of graft composition on the outcome of reduced-intensity (RIC) allogeneic PBSC transplantation (allo-PBSC) remains controversial. In this study, we analyzed the impact of CD34+ cell dose on the incidence of GVHD, and on the outcome after allo-PBSC, in 103 patients with hematological malignancies, using a uniform RIC regimen. The following variables were included in statistical analysis: (1) number of C34+ cells, (2) high-risk vs low-risk disease status, (3) matched related vs matched unrelated donor, (4) female donor to male recipient vs any other combination, (5) age of recipient (above vs below the median). Univariate and multivariate analysis did not reveal any association between CD34+ cell dose and acute grade-2 to grade-4, cGVHD, non-relapse mortality (NRM), relapse rate (RR) and OS. High-risk disease status was the only variable independently associated with increased NRM ( P =0.001), increased RR ( P =0.012) and decreased OS ( P <0.001). The same results were obtained when analysis was restricted to a subgroup of 55 patients with myeloid neoplasms. The influence of graft composition on the outcome of RIC allo-PBSC should be further investigated via well-controlled randomized prospective studies.