Faculty Collaboration Database

Higher infused CD34+ cell dose and overall survival in patients undergoing in vivo T-cell depleted, but not t-cell repleted, allogeneic peripheral blood hematopoietic cell transplantation. Hematol Oncol Stem Cell Ther 2011;4(4):149-56

Date

12/27/2011

Pubmed ID

22198185

DOI

10.5144/1658-3876.2011.149

Scopus ID

2-s2.0-84855498804 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND AND OBJECTIVES: Understanding the effect of cellular graft composition on allogeneic hematopoietic cell transplantation (AHCT) outcomes is an area of great interest. The objective of the study was to analyze the correlation between transplant-related outcomes and administered CD34+, CD3+, CD4+ and CD8+ cell doses in patients who had undergone peripheral blood, AHCT and received either in vivo T-cell depleted or T-cell replete allografts.

DESIGN AND SETTING: Comparison of consecutive patients who underwent peripheral blood AHCT in our institution between January 2003 and December 2009.

PATIENTS AND METHODS: The cohort of 149 patients was divided into two groups; non T-cell depleted (NTCD) (n=54) and T-cell depleted (TCD) (n=95). Study endpoints were overall survival (OS), progression free survival (PFS), engraftment kinetics (neutrophil and platelet recovery), incidence of acute graft versus host disease (acute GVHD), chronic GVHD, nonrelapse mortality (NRM) and disease relapse.

RESULTS: Multivariate analysis showed that higher infused CD34+ cell dose improved OS (relative risk 0.58, 95% CI 0.34-0.98, P=.04), PFS (relative risk 0.59, 95% CI 0.35-1.00, P=.05) and NRM (relative risk 0.49, 95% CI 0.24-0.99, P=.048) in the TCD group. By multivariate analysis, there was no difference in engraftment, grades II-IV acute GVHD, extensive chronic GVHD and relapse in the two groups relative to the infused cell doses. There was a trend towards improved OS (relative risk 0.54, 95% CI 0.29-1.01, P=.05) with higher CD3+ cell dose in the TCD group.

CONCLUSION: Our findings suggest that higher CD34+ cell dose imparts survival benefit only to in vivo TCD peripheral blood AHCT recipients.

Author List

Kanate AS, Craig M, Cumpston A, Saad A, Hobbs G, Leadmon S, Bunner P, Watkins K, Bulian D, Gibson L, Abraham J, Remick SC, Hamadani M

Author

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin

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

Adolescent
Adult
Aged
Antigens, CD34
Cohort Studies
Disease-Free Survival
Female
Graft Survival
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Kaplan-Meier Estimate
Leukemia
Lymphocyte Depletion
Male
Middle Aged
Peripheral Blood Stem Cell Transplantation
T-Lymphocytes
Transplantation, Homologous
Young Adult