HLA-identical stem cell transplantation: is there an optimal CD34 cell dose?

Heimfeld, Shelly

doi:10.1038/sj.bmt.1704019

Cited by 49 publications

(50 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results should highlight the need for further investigation into the range of characteristics that constitute an 'optimal' PBPC allograft. [26][27][28] There appeared to be a modest dose-response effect with GM-CSF since donors mobilized greater total numbers of CD34 þ cells following an increase in the dose of GM-CSF to 15 mg/kg/day. However, we noted that the kinetics of CD34 þ mobilization in the GM10 group were more gradual in comparison to G-CSF, with peak CD34 þ cell levels achieved on days 6-7 rather than the typical days 4-5 peak observed following G-CSF.…”

Section: Discussionmentioning

confidence: 99%

Reduced risk of acute GVHD following mobilization of HLA-identical sibling donors with GM-CSF alone

Devine

Brown

Trinkaus

et al. 2005

Bone Marrow Transplant

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Reduced risk of acute GVHD following mobilization of HLA-identical sibling donors with GM-CSF alone

Devine

Brown

Trinkaus

et al. 2005

Bone Marrow Transplant

View full text Add to dashboard Cite

“…The relationship between a T-cell dose in the graft and aGVHD has not been consistently studied in children, whereas the results obtained in adult patients are controversial. 11,[22][23][24] Both increasing CD3 þ and CD34 þ cell doses were risk factors for aGVHD in a recent study of 315 patients given CD34 þ selected HLA-identical sibling PBSC grafts despite post transplant GVHD prophylaxis in all but six patients. 25 Interestingly, in this study the CD3 þ cell dose correlated with aGVHD was much less than the dose given to our patients (median: 0.05-0.1 Â 10 6 /kg vs 455.3 Â 10 6 /kg, respectively) and the rate of GVHD remained stable with CD3 þ dose over 0.1 Â 410 6 /kg.…”

Section: Discussionmentioning

confidence: 99%

Higher CD3+ and CD34+ cell doses in the graft increase the incidence of acute GVHD in children receiving BMT for thalassemia

Gaziev

Isgrò

Marziali

et al. 2011

Bone Marrow Transplant

View full text Add to dashboard Cite

We evaluated the incidence of GVHD, risk factors and the impact of graft composition on acute GVHD (aGVHD) in 92 children who underwent BMT for thalassemia following busulfan/cyclophosphamide (BUCY)-based conditioning regimens and GVHD prophylaxis with CSA/short-MTX and methylprednisolone. The incidence of grade 2-4 and 3-4 aGVHD was 35% (95% confidence interval (CI) 25-44) and 9% (95% CI 4-16), respectively. We found that CD3 þ and CD34 þ cell doses above the median were associated with high incidence of grade 2-4 aGVHD (49 vs 20%, P ¼ 0.005 and 46 vs 23%, P ¼ 0.021, respectively). In multivariate analysis, high CD3 þ (hazard ratio (HR) 4.6; 95% CI 1.4-14.7; P ¼ 0.010) and CD34 þ (HR 4.3; 95% CI 1.4-12.7; P ¼ 0.011) cell doses were associated with grade 2-4 aGVHD. We further examined the effect of CD3 þ and CD34 þ cell doses on aGVHD using quartile cutoff points and found a minimum threshold for CD3 þ (38 Â 10 6 /kg) and CD34 þ (4 Â 10 6 /kg) cells above which the incidence of grade 2-4 aGVHD is significantly increased. This study shows for the first time a positive correlation between the number of CD3 þ and CD34 þ cells and aGVHD in children receiving sibling BMT, and indicates that using tailored and more intensive post transplant immunosuppression may permit to better control aGVHD.

show abstract

“…The existing recommendations about the minimum number of HSCs to be used for transplantation have been acquired predominantly from retrospective data. 3,5,6 There are reports demonstrating faster neutrophil or platelet engraftment with increasing doses of HSCs in the autologous setting. 5,7,8 The numbers of HSC to be transplanted during BMT is calculated by dividing the total number of cells infused to the actual body weight.…”

Section: Introductionmentioning

confidence: 99%

Is it time to revisit our current hematopoietic progenitor cell quantification methods in the clinic?

Beksaç

Preffer

2011

Bone Marrow Transplant

View full text Add to dashboard Cite

In the clinical practice of hematopoietic SCT, the minimum numbers of cells required for a successful engraftment are defined on the basis of their CD45 and CD34 expression profiles. However, the quantity of earlier progenitors or CD34-positive cells at different differentiation stages within stem cell grafts is not generally taken into consideration. During the last decade, various teams have quantified the number of cells expressing various combinations of CD34, CD38, CD133, CD90 co-expression and/or aldehyde dehydrogenase functional capacity using flow cytometry. Some of these studies resulted in the greater appreciation that combinations of these Ags were associated with varied myeloid, erythroid and platelet engraftment rates whereas others showed that the relative absence or presence of these markers could define cells responsible for either short-or long-term engraftment. These findings were also extended to differences between progenitor cell populations found within BM vs peripheral or cord-blood grafts. Cells harvested from donors are also generally frozen and stored; thawed cells have variable levels of viability and functional capacity based on the time tested post thaw, which also can be assessed by flow cytometry. Finally, flow cytometry has the potential for analysis of cells carrying a mesenchymal stem cell phenotype, which may be quiescent within some of the stem cell products. This review will address the need for stem cell subpopulation quantification and summarize existing published data to identify some Ags and functional characteristics that can be applicable to daily clinical practice.

show abstract

HLA-identical stem cell transplantation: is there an optimal CD34 cell dose?

Cited by 49 publications

References 51 publications

Reduced risk of acute GVHD following mobilization of HLA-identical sibling donors with GM-CSF alone

Reduced risk of acute GVHD following mobilization of HLA-identical sibling donors with GM-CSF alone

Higher CD3+ and CD34+ cell doses in the graft increase the incidence of acute GVHD in children receiving BMT for thalassemia

Is it time to revisit our current hematopoietic progenitor cell quantification methods in the clinic?

Contact Info

Product

Resources

About