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Hodgkin's Disease

High-dose therapy in patients with Hodgkin's disease: the use of selected CD34+ cells is as safe as unmanipulated peripheral blood progenitor cells

Bone Marrow Transplantation volume 28, pages 849–857 (2001)Cite this article

Abstract

Register data suggest that patients with Hodgkin's disease (HD) given high-dose therapy (HDT) with peripheral blood progenitor cells (PBPC) have a less favourable prognosis as compared to those given bone marrow as stem cell support. Since this can be due to infusion of tumour cells contaminating the PBPC grafts, we initiated a feasibility study in which PBPC grafts from HD patients were purged by CD34+ cell enrichment. Controversy exists about whether the use of CD34+ enriched stem cells leads to a delayed haematological and immune reconstitution. We compared these parameters, including risk of infections and clinical outcome after HDT, in patients with HD given either selected CD34+ cells or unmanipulated PBPC as stem cell support. From October 1994 to May 2000, 40 HD patients with primary refractory disease or relapse were treated with HDT and supported with either selected CD34+ cells (n = 21) or unmanipulated PBPC (n = 19) as stem cell support. All patients had chemosensitive disease at the time of transplantation. A median of 5.8 (range 2.7–20.0) vs 4.5 (range 2.3–17.6) × 106 CD34+ cells per kilo were reinfused in the CD34+ group and PBPC group, respectively. No difference was observed between the two groups with regard to time to haematological engraftment, reconstitution of B cells, CD56+ cells and T cells at 3 and 12 months and infectious episodes after HDT. Two (5%) treatment-related deaths, one in each group, were observed. The overall survival at 4 years was 86% for the CD34+group and 74% for the PBPC group with a median follow-up of 37 months (range 1–61) and 46 months (range 4–82), respectively (P = 0.9). The results of this study demonstrate that the use of CD34+ cells is safe and has no adverse effects either with respect to haematological, immune reconstitution or to infections after HDT. Bone Marrow Transplantation (2001) 28, 849–857.

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Acknowledgements

This work was supported by The Norwegian Cancer Society. We give special thanks to Erling Jacobsen, Leiv Rusten and the staff at the Clinical Stem Cell Laboratory and the Central Laboratory, Kari Hildrum at Department of Immunology for technical assistance, the staff at the transplantation unit and Eva Skovlund for assistance with the statistical analysis.

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Authors and Affiliations

  1. Department of Oncology, The Norwegian Radium Hospital, Oslo, Norway

    AK Blystad, H Holte, S Kvaløy & G Kvalheim

  2. Department of Immunology, The Norwegian Radium Hospital, Oslo, Norway

    E Smeland

  3. Department of Pathology, The Norwegian Radium Hospital, Oslo, Norway

    J Delabie

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  1. AK Blystad
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Blystad, A., Holte, H., Kvaløy, S. et al. High-dose therapy in patients with Hodgkin's disease: the use of selected CD34+ cells is as safe as unmanipulated peripheral blood progenitor cells. Bone Marrow Transplant 28, 849–857 (2001). https://doi.org/10.1038/sj.bmt.1703244

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