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Blood, 24 September 2009, Vol. 114, No. 13, pp. 2606-2616. Prepublished online as a Blood First Edition Paper on July 16, 2009; DOI 10.1182/blood-2009-03-208355. This Article Full Text Full Text (PDF) Supplemental Table All Versions of this Article: blood-2009-03-208355v1 114/13/2606    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Pulsipher, M. A. Articles by Confer, D. L. PubMed PubMed Citation Articles by Pulsipher, M. A. Articles by Confer, D. L. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Donor, recipient, and transplant characteristics as risk factors after unrelated donor PBSC transplantation: beneficial effects of higher CD34+ cell dose Michael A. Pulsipher1, Pintip Chitphakdithai2, Brent R. Logan3, Susan F. Leitman4, Paolo Anderlini5, John P. Klein3, Mary M. Horowitz3, John P. Miller6, Roberta J. King2, and Dennis L. Confer6 1 University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City; 2 Center for International Blood and Marrow Transplant Research, Minneapolis, MN; 3 Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee; 4 National Institutes of Health, Clinical Center, Bethesda, MD; 5 University of Texas M. D. Anderson Cancer Center, Houston; and 6 National Marrow Donor Program, Minneapolis, MN We report outcomes of 932 recipients of unrelated donor peripheral blood stem cell hematopoietic cell transplantation (URD-PBSC HCT) for acute myeloid leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome enrolled on a prospective National Marrow Donor Program trial from 1999 through 2003. Preparative regimens included myeloablative (MA; N = 611), reduced-intensity (RI; N = 160), and nonmyeloablative (NMA; N = 161). For MA recipients, CD34+ counts greater than 3.8 x 106/kg improved neutrophil and platelet engraftment, whereas improved overall survival (OS) and reduced transplant-related mortality (TRM) were seen for all preparative regimens when CD34+ cell doses exceeded 4.5 x 106/kg. Higher infused doses of CD34+ cell dose did not result in increased rates of either acute or chronic graft-versus-host disease (GVHD). Three-year OS and disease-free survival (DFS) of recipients of MA, RI, and NMA approaches were similar (33%, 35%, and 32% OS; 33%, 30%, and 29% DFS, respectively). In summary, recipients of URD-PBSC HCT receiving preparative regimens differing in intensity experienced similar survival. Higher CD34+ cell doses resulted in more rapid engraftment, less TRM, and better 3-year OS (39% versus 25%, MA, P = .004; 38% versus 21% RI/NMA, P = .004) but did not increase the risk of GVHD. This trial was registered at www.clinicaltrials.gov as #NCT00785525 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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