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Prepublished online as a Blood First Edition Paper on September 12, 2002; DOI 10.1182/blood-2002-05-1615. This Article Full Text (PDF) All Versions of this Article: 2002-05-1615v1 101/2/446    most recent Alert me when this article is cited Alert me if a correction is posted 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 HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Elmaagacli, A. H Articles by Beelen, D. W Search for Related Content PubMed PubMed Citation Articles by Elmaagacli, A. H Articles by Beelen, D. W Social Bookmarking                   What's this? Submitted June 4, 2002 Accepted August 22, 2002 Outcome of transplantation of highly purified peripheral blood CD34+ cells with T cell add-back compared to unmanipulated bone marrow or peripheral blood stem cells from HLA-identical sibling donors in patients with first chronic phase chronic myeloid leukemia Ahmet H Elmaagacli*, Rudolf Peceny, Nina Steckel, Rudolf Trenschel, Hellmut Ottinger, Hans Grosse-Wilde, Ulrich W Schaefer, and Dietrich W Beelen Bone Marrow Transplantation, University Hospital Essen, Essen, Germany Institute of Immunology, University Hosptial Essen, Essen, Germany * Corresponding author; email: ahmet.elmaagacli{at}uni-essen.de. Outcomes of highly purified CD34+ peripheral blood stem cell transplantation (PBSCT) for chronic phase CML (n=32) were compared to those of PBSCT (n=19) and of bone marrow transplantation (BMT) (n=22) in the HLA-compatible sibling donor setting. Median follow-up was 18 months after CD34+-PBSCT and unmanipulated PBSCT and 20 months after BMT. CD34+-PBSCT was associated with delayed T cell immune reconstitution at 3 months and 12 months post transplant compared with PBSCT (P<0.001) or BMT (NS). The estimated probability of grade II - IV acute graft-versus-host disease (GVHD) was 60% ± 13% for the PBSCT group, 37% ± 13% for the BMT group and only 14% ± 8% for the CD34+-PBSCT group (CD34-PBSCT versus BMT P<0.01 and CD34-PBSCT versus PBSCT P<0.001). The probabilities for molecular relapse were 88% for CD34+-PBSCT, 55% after BMT and 37% after PBSCT (CD34+PBSCT versus PBSCT P<0.03). Cytogenetic relapse probability were 58% after CD34+-PBSCT, 42% after BMT, and 28% after PBSCT (NS). 26 of 32 patients after CD34+-PBSCT received a T cell add-back. Hematologic relapse occurred in 4 of 22 patients after BMT, in 3 of 19 patients after PBSCT and only in 1 of 32 patients after CD34+-PBSCT. The occurrence of an hematologic relapse in patients receiving CD34+-PBSCT was prevented by donor leukocyte infusions, which were applied at a median of 4 times (range 1-7) with a median T cell dose of 3.3x106 x kg/body weight [at a median] beginning at day 120 (75-660 days). The estimated probability of 3-year-survival after transplant was 90% in the CD34+-PBSCT, 68% in the PBSCT group, and 63% in the BMT group, respectively (CD34-PBSCT versus BMT P<0.01 and CD34-PBSCT versus PBSCT P<0.03). Transplantation of CD34+-PBSCs with T cell add-back for patients with CML in 1st chronic phase seems to be safe and is an encouraging alternative transplant procedure to BMT or PBSCT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. A. Jakubowski, T. N. Small, J. W. Young, N. A. Kernan, H. Castro-Malaspina, K. C. Hsu, M.-A. Perales, N. Collins, C. Cisek, M. Chiu, et al. T cell depleted stem-cell transplantation for adults with hematologic malignancies: sustained engraftment of HLA-matched related donor grafts without the use of antithymocyte globulin Blood, December 15, 2007; 110(13): 4552 - 4559. [Abstract] [Full Text] [PDF] M. Ditschkowski, A. H. Elmaagacli, R. Trenschel, R. Peceny, M. Koldehoff, C. Schulte, and D. W. Beelen T-cell depletion prevents from bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia after allogeneic hematopoietic stem cell transplantation with related donors Haematologica, April 1, 2007; 92(4): 558 - 561. [Abstract] [Full Text] [PDF] B. N. Savani, K. Rezvani, S. Mielke, A. Montero, R. Kurlander, C. S. Carter, S. Leitman, E. J. Read, R. Childs, and A. J. Barrett Factors associated with early molecular remission after T cell-depleted allogeneic stem cell transplantation for chronic myelogenous leukemia Blood, February 15, 2006; 107(4): 1688 - 1695. [Abstract] [Full Text] [PDF] J. F. Apperley Managing the Patient with Chronic Myeloid Leukemia Through and After Allogeneic Stem Cell Transplantation Hematology, January 1, 2006; 2006(1): 226 - 232. [Abstract] [Full Text] [PDF] J. H. Antin A 41-Year-Old Woman With Chronic Myelogenous Leukemia JAMA, August 27, 2003; 290(8): 1083 - 1090. [Full Text] [PDF]

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