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Stem Cell Dosage

Increased stem cell dose, as obtained using currently available technology, may not be sufficient for engraftment of haploidentical stem cell transplants

Bone Marrow Transplantation volume 26, pages 1033–1036 (2000)Cite this article

Abstract

The best strategies for haploidentical stem cell transplants are not known. we used a standard myeloablative pretransplant conditioning regimen (30 mg/kg vp-16, 120 mg/kg cyclophosphamide, and 12 gy of tbi in six fractions), an increased peripheral stem cell dose of >10 × 106 CD34+ cells/kg, T cell depletion (with CD34+cell selection and CD4/CD8 depletion steps) to <1 × 105 CD3+ cells/kg and cyclosporine post transplant. Ten patients (7M/3F, median age 11 (3–33) years) with high-risk leukemia (AML in 4, MDS in 2, CML in 1 and T-ALL in 3) received a hemopoietic stem cell transplant (HSCT) from a haploidentical father or sibling. The median number of CD34+ cells was 12.9 (9.5–45.7) × 106 cells/kg; median number of CD3+ cells was 0.41 (0.09–1.89) × 105 CD3+ cells/kg. All patients initially achieved 0.5 × 109/l neutrophils at a median 12 (10–21) days. graft failure in two consecutive patients out of four on the original protocol led to a modification adding atg pretransplant and okt3 post transplant. graft failure was observed in one out of six subsequent patients. acute gvhd ⩾grade ii was observed in three patients. three of 10 patients are alive in cr at >24 and >3 (2) months after transplant. Seven patients died: four of transplant related complications and three of relapse. Increased stem cell dose (⩾10 × 106 CD34+ cells/kg) as obtained using currently available technology may not be sufficient to ensure stable engraftment in patients with high-risk leukemia using standard myeloablative conditioning regimens. Bone Marrow Transplantation (2000) 26, 1033–1036.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Basel University Hospital, Switzerland

    JR Passweg, M Gregor, G Favre & A Gratwohl

  2. Division of Pediatric Hematology/Oncology, Basel University Hospital, Switzerland

    T Kühne & P Avoledo

  3. Hematology Laboratory, Department of Central Laboratories, Basel University Hospital, Switzerland

    A Tichelli

Authors
  1. JR Passweg
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  2. T Kühne
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  3. M Gregor
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  4. G Favre
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  5. P Avoledo
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  6. A Tichelli
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  7. A Gratwohl
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Passweg, J., Kühne, T., Gregor, M. et al. Increased stem cell dose, as obtained using currently available technology, may not be sufficient for engraftment of haploidentical stem cell transplants. Bone Marrow Transplant 26, 1033–1036 (2000). https://doi.org/10.1038/sj.bmt.1702669

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