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

Bone Marrow Transplant. 2003 May;31(10):839-45. doi: 10.1038/sj.bmt.1704019.

Abstract

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 x 10(6)/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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antigens, CD34 / blood
  • Antigens, CD34 / immunology*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / mortality
  • HLA Antigens / immunology*
  • Humans
  • Stem Cell Transplantation / adverse effects
  • Stem Cell Transplantation / methods*
  • Stem Cell Transplantation / mortality

Substances

  • Antigens, CD34
  • HLA Antigens