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Analysis of CD34 + cell subsets in stem cell harvests can more reliably predict rapidity and durability of engraftment than total CD34 + cell dose, but steady state levels do not correlate with bone marrow reserve
Author(s) -
Pratt G.,
Rawstron A. C.,
English A. E.,
Johnson R. J.,
Jack A. S.,
Morgan G. J.,
Smith G. M.
Publication year - 2001
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2001.03027.x
Subject(s) - cd34 , cd38 , stem cell , progenitor cell , haematopoiesis , transplantation , granulocyte colony stimulating factor , andrology , stem cell factor , immunology , medicine , biology , microbiology and biotechnology , chemotherapy
In peripheral blood stem cell transplantation (PBSCT), the number of CD34 + cells transplanted has been shown to correlate well with both rapidity and durability of engraftment. However, it is clear that engraftment does not necessarily correlate with total CD34 + cell numbers in some patients. Consequently, there is increasing interest in evaluating the role of CD34 + subsets in haemopoietic recovery as a more accurate marker of harvest quality. We analysed the numbers of CD34 + cell subsets, namely Thy‐1 + , L‐Selectin + and CD38 − , and correlated this with engraftment in 86 patients undergoing PBSCT. Adequate engraftment was defined as being a platelet count greater than 50 × 10 9 /l and a neutrophil count greater than 1·0 × 10 9 /l. CD34 + L‐Selectin + provided the best prediction of engraftment rapidity, although the improvement over total CD34 + cell dose was minor. Only the dose of CD34 + Thy‐1 + cells transplanted correlated with durable engraftment. The probability of adequate 3‐month engraftment increased with the dose of CD34 + cells transplanted, but 10% of patients receiving > 5 × 10 6 /kg still showed poor engraftment at 3 months. However, all patients receiving > 2·5 × 10 5 /kg CD34 + Thy‐1 + showed adequate engraftment at this time point. We also demonstrated that CD34 + Thy‐1 + progenitors were restricted to the bone marrow under normal conditions and, during stem cell mobilization, their kinetics generally paralleled total CD34 + numbers.