High doses of transplanted CD34+ cells are associated with rapid T-cell engraftment and lessened risk of graft rejection, but not more graft-versus-host disease after nonmyeloablative conditioning and unrelated hematopoietic cell transplantation
- 17 March 2005
- journal article
- research article
- Published by Springer Nature in Leukemia
- Vol. 19 (5) , 822-828
- https://doi.org/10.1038/sj.leu.2403718
Abstract
This report examines the impact of graft composition on outcomes in 130 patients with hematological malignancies given unrelated donor granulocyte-colony-stimulating-factor-mobilized peripheral blood mononuclear cells (G-PBMC) (n=116) or marrow (n=14) transplantation after nonmyeloablative conditioning with 90 mg/m2 fludarabine and 2 Gy TBI. The median number of CD34+ cells transplanted was 6.5 × 106/kg. Higher numbers of grafted CD14+ (P=0.0008), CD3+ (P=0.0007), CD4+ (P=0.001), CD8+ (P=0.004), CD3–CD56+ (P=0.003), and CD34+ (P=0.0001) cells were associated with higher levels of day 28 donor T-cell chimerism. Higher numbers of CD14+ (P=0.01) and CD34+ (P=0.0003) cells were associated with rapid achievement of complete donor T-cell chimerism, while high numbers of CD8+ (P=0.005) and CD34+ (P=0.01) cells were associated with low probabilities of graft rejection. When analyses were restricted to G-PBMC recipients, higher numbers of grafted CD34+ cells were associated with higher levels of day 28 donor T-cell chimerism (P=0.01), rapid achievement of complete donor T-cell chimerism (P=0.02), and a trend for lower risk for graft rejection (P=0.14). There were no associations between any cell subsets and acute or chronic GVHD nor relapse/progression. These data suggest more rapid engraftment of donor T cells and reduced rejection rates could be achieved by increasing the doses of CD34+ cells in unrelated grafts administered after nonmyeloablative conditioning.Keywords
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