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A higher number of infused CD34+ cells has a positive impact on the clinical outcome after related PBSC transplantation

Bone Marrow Transplantation volume 49, pages 1113–1115 (2014)Cite this article

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There is still some controversy regarding the optimal infused CD34+ dose in allogeneic PBSC transplantation (PBSCT). Several studies have reported that a higher dose of CD34+ cells was associated with a decreased risk of non-relapse mortality (NRM).1,2 Other authors found that a higher dose of CD34+ cells was associated with a lower relapse rate.3,4 In contrast, several studies have reported that a higher dose of infused CD34+ cells was associated with an increased risk of acute or chronic GVHD, which was associated with an inferior overall outcome.5,6 Thus, the present study analyzed the impact of the infused CD34+ cell dose on the outcome in related PBSCT.

We retrospectively studied a cohort of 106 adult patients with hematological malignant diseases who received the first related PBSCT at our institute between January 2006 and December 2011. We excluded patients who received haploidentical SCT. The study was approved by the institutional review board of the National Cancer Center, Tokyo, Japan. The probabilities of OS and PFS were calculated with the Kaplan–Meier method. Cumulative incidences of engraftment, NRM, relapse and GVHD were estimated by Gray’s method.7 Variables included in the multivariate analysis were infused cell dose, patient age (linear), donor age (linear), disease stage (early, intermediate or late), conditioning regimen (myeloablative (MAC) or reduced-intensity (RIC)), HLA matching in the GVH direction (matched or 1 locus mismatch), sex mismatch (female to male or other), GVHD prophylaxis (CYA or tacrolimus based), use of MTX, use of antithymocyte globulin (ATG), and year of transplant (2006–2008 or 2009–2011). All statistical analyses were performed with EZR (Saitama Medical Center, Jichi Medical University).8

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References

  1. Bittencourt H, Rocha V, Chevret S, Socie G, Esperou H, Devergie A et al. Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after HLA-identical sibling bone marrow transplantation. Blood 2002; 99: 2726–2733.

    Article  CAS  Google Scholar 

  2. Pulsipher MA, Chitphakdithai P, Logan BR, Leitman SF, Anderlini P, Klein JP et al. Donor, recipient, and transplant characteristics as risk factors after unrelated donor PBSC transplantation: beneficial effects of higher CD34+ cell dose. Blood 2009; 114: 2606–2616.

    Article  CAS  Google Scholar 

  3. Nakamura R, Auayporn N, Smith DD, Palmer J, Sun JY, Schriber J et al. Impact of graft cell dose on transplant outcomes following unrelated donor allogeneic peripheral blood stem cell transplantation: higher CD34+ cell doses are associated with decreased relapse rates. Biol Blood Marrow Transplant 2008; 14: 449–457.

    Article  CAS  Google Scholar 

  4. Bahceci E, Read EJ, Leitman S, Childs R, Dunbar C, Young NS et al. CD34+ cell dose predicts relapse and survival after T-cell-depleted HLA-identical haematopoietic stem cell transplantation (HSCT) for haematological malignancies. Br J Haematol 2000; 108: 408–414.

    Article  CAS  Google Scholar 

  5. Mohty M, Bilger K, Jourdan E, Kuentz M, Michallet M, Bourhis JH et al. Higher doses of CD34+ peripheral blood stem cells are associated with increased mortality from chronic graft-versus-host disease after allogeneic HLA-identical sibling transplantation. Leukemia 2003; 17: 869–875.

    Article  CAS  Google Scholar 

  6. Dhedin N, Prebet T, De Latour RP, Katsahian S, Kuentz M, Piard N et al. Extensive chronic GVHD is associated with donor blood CD34+ cell count after G-CSF mobilization in non-myeloablative allogeneic PBSC transplantation. Bone Marrow Transplant 2012; 47: 1564–1568.

    Article  CAS  Google Scholar 

  7. Fine JP, Gray RJ . A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 1999; 94: 496–509.

    Article  Google Scholar 

  8. Kanda Y . Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant 2013; 48: 452–458.

    Article  CAS  Google Scholar 

  9. Stiehl T, Ho AD, Marciniak-Czochra A . The impact of CD34+ cell dose on engraftment after SCTs: personalized estimates based on mathematical modeling. Bone Marrow Transplant 2014; 49: 30–37.

    Article  CAS  Google Scholar 

  10. Ishaqi MK, Afzal S, Dupuis A, Doyle J, Gassas A . Early lymphocyte recovery post-allogeneic hematopoietic stem cell transplantation is associated with significant graft-versus-leukemia effect without increase in graft-versus-host disease in pediatric acute lymphoblastic leukemia. Bone Marrow Transplant 2008; 41: 245–252.

    Article  CAS  Google Scholar 

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Acknowledgements

This work was supported by grants from the Japanese Ministry of Health, Labour and Welfare and the National Cancer Research and Development Fund (23–A–28).

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Authors and Affiliations

  1. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan,

    K Maie, S Fuji, K Tajima, M Tatsuno, S Yamagata, N Takahashi, R Ueda, H Hashimoto, K Takano, Y Inoue, A Ito, Y Hayashi, K Okinaka, S Kurosawa, S-W Kim, Y Heike, T Yamashita & T Fukuda

  2. Department of Hematology, University of Tsukuba, Tsukuba, Japan,

    K Maie

  3. Department of Blood Transfusion and Cellular Therapy, National Cancer Center Hospital, Tokyo, Japan,

    R Tanosaki

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  1. K Maie
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  2. S Fuji
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Corresponding author

Correspondence to S Fuji.

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Maie, K., Fuji, S., Tajima, K. et al. A higher number of infused CD34+ cells has a positive impact on the clinical outcome after related PBSC transplantation. Bone Marrow Transplant 49, 1113–1115 (2014). https://doi.org/10.1038/bmt.2014.94

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