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CD34 selection for bone marrow transplants for children with genetic diseases

Bone Marrow Transplantation volume 33, page 351 (2004)Cite this article

A recent article reported the use of CD34 selected bone marrow for eight patients with genetic diseases.1 The summary states that all patients engrafted and none developed GVHD. However, our clinical experience and closer analysis of the series of Gaipa et al is worthy of further comment.

Gaipa et al report the use of unrelated BM subjected to T- and B-cell depletion by the use of positive selection for CD34 using the CliniMACS device and with a T-cell add back on day 0 to provide 0.3–0.5 × 106 CD3 cells/kg. However, two of the cases of mucopolysaccharidosis type 1 (MPS-1H) were second BMTs. The authors had already commented on the propensity of MPS-1 patients to reject their first BMT. After having been conditioned once, a second procedure is more likely to achieve engraftment. If one considers the six first BMT procedures, only three out of six achieved full engraftment. Furthermore, none of the three first BMTs for MPS-1 achieved full donor chimerism.

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References

  1. Gaipa G, Dassi M, Perseghin P et al. Allogeneic bone marrow stem cell transplantation following CD34+ immunomagnetic enrichment in patients with inherited metabolic storage diseases. Bone Marrow Transplant 2003; 31: 857–860.

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  1. BMT Service, Children's Hospital at Westmead, Westmead, NSW 2145, Sydney, Australia

    P J Shaw & M Bleakley

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  1. P J Shaw
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  2. M Bleakley
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Shaw, P., Bleakley, M. CD34 selection for bone marrow transplants for children with genetic diseases. Bone Marrow Transplant 33, 351 (2004). https://doi.org/10.1038/sj.bmt.1704351

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