Faculty Collaboration Database

The effect of the composition of unrelated donor bone marrow and peripheral blood progenitor cell grafts on transplantation outcomes. Biol Blood Marrow Transplant 2010 Feb;16(2):253-62

Date

10/14/2009

Pubmed ID

19822219

Pubmed Central ID

PMC2952392

DOI

10.1016/j.bbmt.2009.10.004

Scopus ID

2-s2.0-75449094602 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

To test the hypothesis that the outcome of hematopoietic stem cell (HSC) grafts is at least partially determined by the cellular composition of the graft, the National Marrow Donor Program (NMDP) analyzed the correlation of cellular phenotypes of unrelated grafts with graft outcome. Samples from 94 bone marrow (BM) and 181 peripheral blood progenitor cell (PBPC) grafts for transplantations at 40 U.S. transplant centers between 2003 and 2005 were analyzed at a single immunophenotyping reference laboratory. Samples were shipped from transplant centers upon receipt of graft. Graft cellular composition included analysis of leukocyte total cell numbers, and subsets of myeloid [CD34(+), CD34(+) CD38(-)], lymphoid [CD3(+), CD3(+) CD4(+), CD3(+) CD8(+)], and activated lymphoid cells [CD3(+) CD25(+), CD3(+) CD69(+), CD3(+) HLA-DR(+)] coexpressing CD3(+). There was substantial variability in the cellular composition of BM and PBPC grafts before and after graft processing by red blood cell (RBC) removal or plasma depletion in preparation for transplant. With BM grafts, cellular composition was not associated with hematopoietic recovery, graft-versus-host disease (GVHD), or survival. With PBPC grafts, survival rates were higher with CD34(+)>5 x 10(6)/kg, 59% compared to 34% with CD34(+)< or =5 x 10(6)/kg at 1 year. Platelet recovery was higher with PBPC containing CD3(+) CD8(+) >8 x 10(7)/kg. Neutrophil recovery or GVHD could not be predicted by any cellular subsets of PBPC grafts. Although survival was superior with PBPC grafts containing >5 x 10(6) CD34(+)/kg, an optimal graft mix of myeloid, lymphoid, and activated lymphoid subsets was not identified.

Author List

Collins NH, Gee AP, Durett AG, Kan F, Zhang MJ, Champlin RE, Confer D, Eapen M, Howard A, King R, Laughlin MJ, Plante RJ, Setterholm M, Spellman S, Keever-Taylor C, Wagner JE, Weisdorf DJ

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Antigens, CD
Bone Marrow Transplantation
Donor Selection
Female
Flow Cytometry
Graft Survival
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Immunophenotyping
Leukocyte Count
Lymphocyte Subsets
Male
Myeloid Cells
Peripheral Blood Stem Cell Transplantation
Phenotype
Registries
Reproducibility of Results
Survival Analysis
Treatment Outcome