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Influence of the different CD34 + and CD34 – cell subsets infused on clinical outcome after non‐myeloablative allogeneic peripheral blood transplantation from human leucocyte antigen‐identical sibling donors
Author(s) -
Menéndez Pablo,
PérezSimón Jose A.,
Mateos Maria V.,
Caballero Maria D.,
González Marcos,
SanMiguel Jesus F.,
Orfao Alberto
Publication year - 2002
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.1365-2141.2002.03794.x
Subject(s) - cd34 , leukapheresis , haematopoiesis , immunology , transplantation , medicine , stem cell , progenitor cell , hematopoietic stem cell transplantation , biology , genetics
Summary. Currently, no information is available regarding the influence of the different CD34 + cell subsets infused on the haematopoietic recovery, following non‐myeloablative allogeneic peripheral blood stem cell transplantation (allo‐PBSCT). We have explored, in a group of 13 patients receiving non‐myeloablative allo‐PBSCT from human leucocyte antigen‐identical sibling donors, the influence of the total dose of CD34 + haematopoietic progenitor cells (HPC) infused, compared with that of the different CD34 + HPC and CD34 – leucocyte subsets in the leukapheresis samples, on both engraftment and clinical outcome. The overall numbers of total CD34 + HPC ( P = 0·002) and myelomonocytic‐committed CD34 + HPC infused ( P = 0·0002) were strongly associated with neutrophil recovery (> 1 × 10 9 neutrophils/l), the latter being the only independent parameter influencing neutrophil recovery. Regarding long‐term engraftment, only the number of immature CD34 + HPC infused/kg correlated with the duration of hospitalization in the first 2 years after discharge ( r = −0·75, P = 0·005). Both the overall amount of CD34 + HPC and the number of myelomonocytic CD34 + HPC infused showed a significant influence on the risk of graft‐versus‐host disease (GVHD). Thus, the overall probability of GVHD was 100% vs 25% for patients receiving ≥ 5 × 10 6 CD34 + HPC or ≥ 3·5 × 10 6 of myelomonocytic‐committed CD34 + HPC vs lower doses ( P = 0·013). None of the other CD34 + and CD34 – cell subsets analysed correlated with development of GVHD. In summary, our results suggest that in non‐myeloablative allo‐PBSCT, high numbers of CD34 + HPC, especially the myelomonocytic‐committed CD34 + progenitors, lead to rapid neutrophil engraftment. However, they also strongly impair clinical outcome by increasing the incidence of GVHD.