Summary:
A review of the published literature, supplemented with a recent analysis of Fred Hutchinson data, has been undertaken to investigate the association of infused CD34 cell dose with various clinical outcomes after HLA-identical transplantation. Separate assessments for unrelated vs related donors and the use of bone marrow or mobilized G-PBMC have been incorporated. The three primary findings are: (1) higher CD34 dose results in better neutrophil and platelet recovery in all settings; (2) high CD34 doses (>8 × 106/kg) are associated with the development of more chronic GVHD when using related G-PBMC; (3) higher CD34 dose is correlated with improved survival after bone marrow transplantation, especially with unrelated donors. This is not seen when using G-PBMC. The data suggest that the CD34 content of the graft can have a significant impact on clinical outcome after allogeneic transplantation, but optimal dose is dependent on both donor type and stem cell source.
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Acknowledgements
This work was supported by NIH Grants HL66947, CA15704, CA18029, DK56465, and HL54881.
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Heimfeld, S. HLA-identical stem cell transplantation: is there an optimal CD34 cell dose?. Bone Marrow Transplant 31, 839–845 (2003). https://doi.org/10.1038/sj.bmt.1704019
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DOI: https://doi.org/10.1038/sj.bmt.1704019
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