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CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study
Author(s) -
Berger Massimo,
Faraci Maura,
Saglio Francesco,
Giardino Stefano,
Ernestina Vassallo Elena,
Prete Arcangelo,
Fagioli Franca
Publication year - 2021
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13909
Subject(s) - cytopenia , medicine , hematopoietic stem cell transplantation , chimera (genetics) , stem cell , transplantation , cd34 , haematopoiesis , bone marrow , hematopoietic stem cell , immunology , biology , genetics , gene , biochemistry
Background PGF is historically associated with high morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Methods In this study, we report our multicenter experience on stem cell boost (SCB) for PGF, or incomplete donor engraftment, in 16 pediatric patients. Donors were HLA‐matched siblings (n = 4), unrelated donors (n = 11), or haploidentical family members (n = 1). Ten patients had two‐lineage cytopenia, 5 had one‐lineage cytopenia, and 1 had poor immunological reconstitution together with a low percentage of donor cell engraftment. A median of 6.6x10 6 selected CD34+/Kg was infused after 194 days from allo‐HSCT (48‐607). Results In 4 out of 5 patients, one‐lineage cytopenia was resolved, while among the 10 patients with two‐lineage cytopenia, 4 resolved both cytopenia, 5 resolved one‐lineage, and one did not respond. All patients reverted their mixed chimera to full donor chimera. OS was 56%, transplant‐related mortality (TRM) 32%, and RI 12%. The main causes of failure were related to infections with 4 out of 7 deaths caused by this. Conclusions SCB may rescue over 50% of patients with PGF after allo‐HSCT. An earlier treatment may reduce the infectious complications and improve survival.