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CD34+ Cell Transplants

Transplantation of highly purified peripheral-blood CD34+ progenitor cells from related and unrelated donors in children with nonmalignant diseases

Bone Marrow Transplantation volume 33, pages 25–32 (2004)Cite this article

Summary:

Transplantation of allogeneic stem cells is currently the only curative treatment for some nonmalignant pediatric diseases. We investigated whether transplantation of purified CD34+ stem cells prevents acute and chronic GvHD and reduces transplant-related mortality. A total of 25 pediatric patients with nonmalignant diseases underwent allogeneic transplantation from 26 donors (matched related n=4, matched or partially matched unrelated n=14, mismatched related n=8). All grafts were purified peripheral-blood CD34+ stem cells mobilized with G-CSF. Patients received a median of 12.9 × 106 CD34+ progenitor cells with a median of 6.1 × 103 contaminating T-lymphocytes per kilogram of body weight. No post transplant immunosuppressive drugs were given for prophylaxis of GvHD. Engraftment was seen in 21 patients. Three patients engrafted after a second transplant and one patient failed to engraft. Two patients had autologous reconstitution 1.5 years post transplant and one of them was successfully retransplanted. No acute GvHD >grade II was seen, and only two patients developed limited, chronic GvHD. In all, 22 patients (88%) are alive with a median follow-up of 3.7 years. In total, 19 patients (76%) are free of disease or of progression. Transplantation of highly purified peripheral-blood CD34+ stem cells is associated with low toxicity in patients with nonmalignant diseases.

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Acknowledgements

We thank Ruben Siedner, Christine Faleyras, Annie Babarin-Dorner, Olga Bartuli, Christiane Braun, Gabi Hochwelker, and Ulrike Krauter for excellent technical assistance and Sharon Naron for excellent editorial assistance. We thank Dr Paul Woodard for critical reading of the manuscript and helpful suggestions. We thank all the volunteers who donated mobilized peripheral stem cells, especially those who were willing to donate a second time if necessary. This work was supported by a grant from the Jose Carreras Foundation (DJCLS-R3) and from the Deutsche Forschungsgemeinschaft (SFB 510).

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Author notes

  1. P Lang and T Klingebiel: PL and TK contributed equally.

Authors and Affiliations

  1. Children's University Hospital, Tübingen, Germany

    P Lang, P Bader, J Greil, M Schumm, M Eyrich & D Niethammer

  2. Children's University Hospital, Frankfurt, Germany

    T Klingebiel

  3. Children's University Hospital, Wuerzburg, Germany

    P-G Schlegel

  4. Children's University Hospital, TU Muenchen, Germany

    S Mueller-Weihrich

  5. St Jude Children's Research Hospital, Memphis, TN, USA

    R Handgretinger

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  1. P Lang
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Correspondence to R Handgretinger.

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Lang, P., Klingebiel, T., Bader, P. et al. Transplantation of highly purified peripheral-blood CD34+ progenitor cells from related and unrelated donors in children with nonmalignant diseases. Bone Marrow Transplant 33, 25–32 (2004). https://doi.org/10.1038/sj.bmt.1704303

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