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The impact of CD34 + cell dose on platelet engraftment in pediatric patients following unmanipulated haploidentical blood and marrow transplantation
Author(s) -
Chang YingJun,
Xu LanPing,
Liu DaiHong,
Liu KaiYan,
Han Wei,
Chen YuHong,
Wang Yu,
Chen Huan,
Wang JingZhi,
Zhang XiaoHui,
Zhao XiangYu,
Huang XiaoJun
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22159
Subject(s) - medicine , univariate analysis , transplantation , platelet , hematopoietic stem cell transplantation , cd34 , haematopoiesis , gastroenterology , multivariate analysis , immunology , stem cell , biology , genetics
Objective Unmanipulated haploidentical blood and marrow transplantation has been developed as an alternative transplant strategy for pediatric patients with hematological diseases. The aim of this study was to investigate the effects of donor and recipient characteristics on hematopoietic recovery in pediatric patients following unmanipulated haploidentical transplantation. Methods Factors correlating with hematopoietic recovery in 133 pediatric patients after unmanipulated haploidentical transplantation were analyzed retrospectively. Results All patients reached an absolute neutrophil count of 500/µl in a median of 12 days (range, 9–49 days). One hundred thirty‐three patients reached an untransfused platelet count of more than 20,000/µl in a median of 15 days (range, 7–180 days). Univariate analysis showed five factors associated with platelet engraftment. These were time to transplantation after diagnosis ( P = 0.072), infused nuclear cells/kg of recipient weight ( P = 0.028), CD3 + cells/kg of recipient weight ( P = 0.082), CD4 + cells/kg of recipient weight ( P = 0.083), and CD34 + cells/kg of recipient weight ( P = 0.012). Multivariate analysis showed that infused CD34 + cells/kg of recipient weight (CD34 + cells more than 2.42 × 10 6 /kg vs. less than or equal to 2.42 × 10 6 /kg, HR = 1.733; 95% CI 1.222–2.549; P = 0.002) were significantly associated with an increased risk of platelet engraftment. Patients receiving a CD34 + cell dose more than 2.42 × 10 6 /kg had a short time [12 days (range, 7–176 days)] to achieve an untransfused platelet engraftment, compared to 18 days (range, 7–180 days) in patients receiving a lower dose ( P < 0.001). Conclusions Our results suggest that low number of CD34 + cells in allografts is a critical factor associated with delayed platelet engraftment after unmanipulated haploidentical transplantation in pediatric patients. Pediatr Blood Cancer 2009;53:1100–1106. © 2009 Wiley‐Liss, Inc.