|
|
 Previous Article | Table of Contents | Next Article 
Blood, 15 April 2002, Vol. 99, No. 8, pp. 2726-2733
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Association of CD34 cell dose with hematopoietic recovery,
infections, and other outcomes after HLA-identical sibling bone marrow
transplantation
Henrique Bittencourt,
Vanderson Rocha,
Sylvie Chevret,
Gérard Socié,
Hélène Espérou,
Agnès Devergie,
Liliane Dal
Cortivo,
Jean-Pierre Marolleau,
Federico Garnier,
Patricia Ribaud, and
Eliane Gluckman
From the Bone Marrow Transplant Unit, Cell Therapy
Laboratory and Biostatistics Unit, Hospital Saint-Louis, Paris, France.
Although CD34 cell dose is known to influence outcome of peripheral
stem cell- and/or T-cell-depleted transplantation, such data on
unmanipulated marrow transplantation are scarce. To study the influence
of CD34+ cell dose on hematopoietic reconstitution and
incidence of infections after bone marrow transplantation, we
retrospectively analyzed 212 patients from January 1994 to August 1999 who received a transplant of an unmanipulated graft from an
HLA-identical sibling donor. Median age was 31 years; 176 patients had
hematologic malignancies. Acute graft-versus-host disease prophylaxis
consisted mainly in cyclosporin associated with methotrexate
(n = 174). Median number of bone marrow nucleated cells and
CD34+ cells infused were 2.4 × 108/kg and
3.7 × 106/kg, respectively. A CD34+ cell
dose of 3 × 106/kg or more significantly influenced
neutrophil (hazard ratio [HR] = 1.37, P = .04),
monocyte (HR = 1.47, P = .02), lymphocyte (HR = 1.70, P = .003), erythrocyte (HR = 1.77, P = .0002), and platelet (HR = 1.98,
P = .00008) recoveries. CD34+ cell dose
also influenced the incidence of secondary neutropenia (HR = 0.60,
P = .05). Bacterial and viral infections were not influenced by CD34 cell dose, whereas it influenced the incidence of
fungal infections (HR = 0.41, P = .008). Estimated
180-day transplantation-related mortality (TRM) and 5-year survival
were 25% and 56%, respectively, and both were highly affected by
CD34+ cell dose (HR = 0.55, P = .006 and
HR = 0.54, P = .03, respectively). Five-year survival
and 180-day TRM were, respectively, 64% and 19% for patients
receiving a CD34+ cell dose of 3 × 106/kg or
more and 40% and 37% for the remainders. In conclusion a
CD34+ cell dose of 3 × 106/kg or more
improved all hematopoietic recoveries, decreased the incidence of
fungal infections and TRM, and improved overall survival.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
E. Clave, M. Busson, C. Douay, R. Peffault de Latour, J. Berrou, C. Rabian, M. Carmagnat, V. Rocha, D. Charron, G. Socie, et al.
Acute graft-versus-host disease transiently impairs thymic output in young patients after allogeneic hematopoietic stem cell transplantation
Blood,
June 18, 2009;
113(25):
6477 - 6484.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Pabst, H. Schirutschke, G. Ehninger, M. Bornhauser, and U. Platzbecker
The Graft Content of Donor T Cells Expressing {gamma}{delta}TCR+ and CD4+foxp3+ Predicts the Risk of Acute Graft versus Host Disease after Transplantation of Allogeneic Peripheral Blood Stem Cells from Unrelated Donors
Clin. Cancer Res.,
May 15, 2007;
13(10):
2916 - 2922.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N.-C. Gorin, M. Labopin, J.-M. Boiron, N. Theorin, T. Littlewood, S. Slavin, H. Greinix, J. Y. Cahn, E. P. Alessandrino, A. Rambaldi, et al.
Results of Genoidentical Hemopoietic Stem Cell Transplantation With Reduced Intensity Conditioning for Acute Myelocytic Leukemia: Higher Doses of Stem Cells Infused Benefit Patients Receiving Transplants in Second Remission or Beyond--The Acute Leukemia Working Party of the European Cooperative Group for Blood and Marrow Transplantation
J. Clin. Oncol.,
August 20, 2006;
24(24):
3959 - 3966.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Z. Pavletic, S. L. Carter, N. A. Kernan, J. Henslee-Downey, A. M. Mendizabal, E. Papadopoulos, R. Gingrich, J. Casper, S. Yanovich, D. Weisdorf, et al.
Influence of T-cell depletion on chronic graft-versus-host disease: results of a multicenter randomized trial in unrelated marrow donor transplantation
Blood,
November 1, 2005;
106(9):
3308 - 3313.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Ades, J.-Y. Mary, M. Robin, C. Ferry, R. Porcher, H. Esperou, P. Ribaud, A. Devergie, R. Traineau, E. Gluckman, et al.
Long-term outcome after bone marrow transplantation for severe aplastic anemia
Blood,
April 1, 2004;
103(7):
2490 - 2497.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Peffault de Latour, V. Levy, T. Asselah, P. Marcellin, C. Scieux, L. Ades, R. Traineau, A. Devergie, P. Ribaud, H. Esperou, et al.
Long-term outcome of hepatitis C infection after bone marrow transplantation
Blood,
March 1, 2004;
103(5):
1618 - 1624.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Socie, J.-Y. Mary, M. Lemann, M. Daneshpouy, P. Guardiola, V. Meignin, L. Ades, H. Esperou, P. Ribaud, A. Devergie, et al.
Prognostic value of apoptotic cells and infiltrating neutrophils in graft-versus-host disease of the gastrointestinal tract in humans: TNF and Fas expression
Blood,
January 1, 2004;
103(1):
50 - 57.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. C. Gorin, M. Labopin, V. Rocha, W. Arcese, M. Beksac, E. Gluckman, O. Ringden, T. Ruutu, J. Reiffers, G. Bandini, et al.
Marrow versus peripheral blood for geno-identical allogeneic stem cell transplantation in acute myelocytic leukemia: influence of dose and stem cell source shows better outcome with rich marrow
Blood,
October 15, 2003;
102(8):
3043 - 3051.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Perez-Simon, M. Diez-Campelo, R. Martino, A. Sureda, D. Caballero, C. Canizo, S. Brunet, A. Altes, L. Vazquez, J. Sierra, et al.
Impact of CD34+ cell dose on the outcome of patients undergoing reduced-intensity-conditioning allogeneic peripheral blood stem cell transplantation
Blood,
August 1, 2003;
102(3):
1108 - 1113.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
