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CD34 + selected stem cell boosts can improve poor graft function after paediatric allogeneic stem cell transplantation
Author(s) -
Mainardi Chiara,
Ebinger Martin,
Enkel Sigrid,
Feuchtinger Tobias,
Teltschik HeikoManuel,
Eyrich Matthias,
Schumm Michael,
Rabsteyn Armin,
Schlegel Patrick,
Seitz Christian,
Schwarze CarlPhillip,
Müller Ingo,
Greil Johann,
Bader Peter,
Schlegel PaulGerhardt,
Martin David,
Holzer Ursula,
Döring Michaela,
Handgretinger Rupert,
Lang Peter
Publication year - 2018
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 - 10.1111/bjh.15012
Subject(s) - medicine , stem cell , transplantation , cd34 , gastroenterology , hematopoietic stem cell transplantation , haematopoiesis , graft versus host disease , immunology , surgery , biology , genetics
Summary Poor graft function ( PGF ) is a severe complication of haematopoietic stem cell transplantation ( HSCT ) and administration of donor stem cell boosts ( SCB s) represents a therapeutic option. We report 50 paediatric patients with PGF who received 61 boosts with CD 34 + selected peripheral blood stem cells ( PBSC ) after transplantation from matched unrelated ( n = 25) or mismatched related ( n = 25) donors. Within 8 weeks, a significant increase in median neutrophil counts (0·6 vs. 1·516 × 10 9 /l, P < 0·05) and a decrease in red blood cell and platelet transfusion requirement (median frequencies 1 and 7 vs. 0, P < 0·0001 and <0·001), were observed, and 78·8% of patients resolved one or two of their cytopenias. 36·5% had a complete haematological response. Median lymphocyte counts for CD 3 + , CD 3 + CD 4 + , CD 19 + and CD 56 + increased 8·3‐, 14·2‐, 22.‐ and 1·6‐fold. The rate of de novo acute graft‐versus‐host disease (Gv HD ) grade I–III was only 6% and resolved completely. No Gv HD grade IV or chronic Gv HD occurred. Patients who responded to SCB displayed a trend toward better overall survival ( OS ) ( P = 0·07). Thus, administration of CD 34 + selected SCB s from alternative donors is safe and effective. Further studies are warranted to clarify the impact on immune reconstitution and survival.