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Comment on ‘CD34+ selected hematopoietic stem cell (HSC) not preceded by any immunosuppressive therapy as effective treatment of graft failure’ – G Milone et al

Bone Marrow Transplantation volume 35, page 522 (2005)Cite this article

Milone et al report a case of graft failure occurring after a T-cell replete allogeneic HSC transplantation that was successfully treated using an infusion of immunoselected HSC without any prior immunosuppression. The authors refer to a similar case from our institution (a 12-year-old boy with sustained low platelet counts after transplantation of unmanipulated bone marrow from his non-identical father, in whom a stem cell boost of purified CD133+ selected peripheral progenitors improved megakaryopoiesis markedly1) and raise the question whether CD34+ selected HSC may be equally effective.

We absolutely agree with the authors: CD133+ selected as well as CD34+ selected HSC have also been used in our institution to improve and to stabilize hematopoiesis after T-cell depleted or T-cell reduced transplantation from alternative donors. Boosts were given between 19 and 498 days and no severe GvHD was induced. Thus, patients in whom transplant tolerance already has been achieved may benefit from boosts with positive (CD34+ or CD133+) selected stem cells also in our experience. Ongoing studies need to clarify if CD133+ selected cells will be more effective than CD34+ selected progenitors, especially in terms of platelet recovery, or not.

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References

  1. Lang P, Klingebiel T, Schumm M et al. Correction of persistent thrombocytopenia by boost of CD133+ selected stem cells in a patient transplanted for Wiskott Aldrich Syndrome 10 years ago. Bone Marrow Transplant 2004; 33: 879–880.

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  1. Department of Pediatric Oncology, University Children's Hospital, Eberhard Karl's Universität, Tübingen, Hoppe Seyler Strasse 1, D 72076, Tübingen, Germany

    P Lang, D Niethammer, P Bader & J Greil

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  1. P Lang
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  2. D Niethammer
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  4. J Greil
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Lang, P., Niethammer, D., Bader, P. et al. Comment on ‘CD34+ selected hematopoietic stem cell (HSC) not preceded by any immunosuppressive therapy as effective treatment of graft failure’ – G Milone et al. Bone Marrow Transplant 35, 522 (2005). https://doi.org/10.1038/sj.bmt.1704809

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