Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Peripheral Blood Stem Cells

Unrelated peripheral blood stem cell transplantation with ‘megadoses’ of purified CD34+ cells in three children with refractory severe aplastic anemia

Bone Marrow Transplantation volume 25, pages 513–517 (2000)Cite this article

Abstract

Three children with refractory severe aplastic anemia were transfused with high numbers of unrelated matched (n = 2) or C-locus haploidentical mismatched (n = 1) CD34-selected peripheral blood stem cells in the absence of an HLA-identical family donor. Two leukaphereses of the donors yielded a median number of 10.1 × 1010nucleated cells (range 9.7–15.4) with a median number of 9.89 × 108CD34+ cells (range 7.46–26.1) and a median percentage of CD34+cells of 0.98% (range 0.77–1.7). After positive selection by magnetic cell sorting the patients received a median of 14.3 × 106 CD34+ cells/kg (range 11.7–24.3) and of 1.3 × 104 CD3+ cells/kg (range 0.57–5.8). Median time to ANC ⩾0.5 × 109/l was 7 days (range 7–12) and to platelets ⩾20 × 109/l 13 days (range 13–27). Chimerism analysis of peripheral blood after transplantation revealed permanent 100% donor hematopoiesis in all patients. The patient with the C-locus haploidentical mismatch presented with acute GVHD (grade III–IV) of the skin, liver and lower gastrointestinal tract (onset day +40) and died despite intensive immunosuppressive treatment on day +238. The two survivors developed lymphopoietic recovery of B and T lymphocytes within 3 months after transplantation. To our knowledge this experience represents the first report of transplantation with unrelated CD34+ enriched peripheral blood stem cell in children with refractory severe aplastic anemia. Bone Marrow Transplantation (2000) 25, 513–517.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Margolis D, Camitta B, Pietryga D et al. Unrelated donor bone marrow transplantation to treat severe aplastic anaemia in children and young adults Br J Haematol 1996 94: 65–72

    Article  CAS  Google Scholar 

  2. Cuthbert RJ, Shepherd JD, Nantel SH et al. Allogeneic bone marrow transplantation for severe aplastic anemia: the Vancouver experience Clin Invest Med 1995 18: 122–130

    CAS  PubMed  Google Scholar 

  3. Davies SM, Wagner JE, Defor T et al. Unrelated donor bone marrow transplantation for children and adolescents with aplastic anaemia or myelodysplasia Br J Haematol 1997 96: 749–756

    Article  CAS  Google Scholar 

  4. Grovas A, Feig SA, O'Rourke S et al. Unrelated donor bone marrow transplants in children Cell Transplant 1994 3: 413–420

    Article  CAS  Google Scholar 

  5. Hows J, Szydlo R, Anasetti C et al. Unrelated donor bone marrow transplants in children Bone Marrow Transplant 1992 10: (Suppl. 1) 102–106

    PubMed  Google Scholar 

  6. Handgretinger R, Lang P, Schumm M et al. Isolation and transplantation of autologous peripheral CD34+ progenitor cells highly purified by magnetic-activated cell sorting Bone Marrow Transplant 1998 21: 987–993

    Article  CAS  Google Scholar 

  7. McNiece I, Briddel R, Stoney G et al. Large-scale isolation of CD34+ cells using the Amgen cell selection device results in high levels of purity and recovery J Hematother 1997 6: 5–11

    Article  CAS  Google Scholar 

  8. Miltenyi S, Müller W, Weichel W, Radbruch A . High gradient magnetic cell separation with MACS Cytometry 1990 11: 231–238

    Article  CAS  Google Scholar 

  9. Mangge H, Beaufort F, Samitz M, Schauenstein K . Peripheral blood of non-leukemic lymphoma patients exhibit aberrant expression of T-cell activation markers after polyclonal stimulation in vitro Cancer 1990 66: 677–683

    Article  CAS  Google Scholar 

  10. Comoli P, Maccario R, Montagna D et al. Expression of p75 chain of IL-2 receptor in the early immunological reconstitution after allogeneic bone marrow transplantation Clin Exp Immunol 1994 97: 510–516

    Article  CAS  Google Scholar 

  11. Tzeng CH, Chen PM, Fan S et al. CY/TBI-800 as a pretransplant regimen for allogeneic bone marrow transplantation for severe aplastic anemia using HLA-haploidentical family donors Bone Marrow Transplant 1996 18: 273–277

    CAS  PubMed  Google Scholar 

  12. Rachamim N, Gan J, Segall H et al. Tolerance induction by ‘megadose’ hematopoietic transplants: donor-type human CD34 stem cells induce potent specific reduction of host anti-donor cytotoxic T lymphocyte precursors in mixed lymphocyte culture Transplantation 1998 65: 1386–1393

    Article  CAS  Google Scholar 

  13. Aversa F, Martelli MM, Reisner Y . Use of stem cells from mismatched related donors Curr Opin Hematol 1997 4: 419–422

    Article  CAS  Google Scholar 

  14. Bachar-Lustig E, Rachamim N, Li HW et al. Megadose of T cell-depleted bone marrow overcomes MHC barriers in sublethally irradiated mice Nature Med 1995 1: 1268–1273

    Article  CAS  Google Scholar 

  15. Aversa F, Tabilio A, Velardi A et al. Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched HLA haplotype New Engl J Med 1998 22: 1186–1193

    Article  Google Scholar 

  16. Körbling M, Huh YO, Durett A et al. Allogeneic blood stem cell transplantation: peripheralization and yield of donor-derived primitive hematopoietic progenitor cells (CD34+ Thy-1dim) and lymphoid subsets, and possible predictors of engraftment and graft-versus-host disease Blood 1995 86: 2842–2848

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Graz, Austria

    W Schwinger, Ch Urban, H Lackner, R Kerbl, M Benesch, HJ Dornbusch & P Sovinz

  2. Department of Pediatrics, University of Tübingen, Germany

    M Schumm & R Handgretinger

  3. Institute of Experimental Pathology, University of Graz, Austria

    K Schauenstein

Authors
  1. W Schwinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ch Urban
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H Lackner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R Kerbl
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Benesch
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. HJ Dornbusch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P Sovinz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K Schauenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M Schumm
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. R Handgretinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schwinger, W., Urban, C., Lackner, H. et al. Unrelated peripheral blood stem cell transplantation with ‘megadoses’ of purified CD34+ cells in three children with refractory severe aplastic anemia. Bone Marrow Transplant 25, 513–517 (2000). https://doi.org/10.1038/sj.bmt.1702202

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702202

Keywords

This article is cited by

Search

Advanced search

Quick links