CD34 Stem Cell Boost in Pediatric Allogeneic Stem Cell Transplant Recipients: A Case Series and Review of Literature

Sara Bowman, Joe Stanek, Rajinder Bajwa, Veronika Polishchuk, Rolla Abu-Arja, Hemalatha G. Rangarajan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Patients with poor graft function (PGF) or declining donor chimerism (DC) post allogeneic hematopoietic cell transplantation (HCT) may benefit from a CD34-selected stem cell boost (SCB). We retrospectively studied outcomes of fourteen pediatric patients (PGF: 12 and declining DC: 2), with a median age of 12.8 (range 0.08–20.6) years at HCT, who received a SCB. Primary and secondary endpoints included resolution of PGF or improvement in DC (≥ 15% increase), overall survival (OS) and transplant-related mortality (TRM), respectively. The median CD34 dose infused was 7.47 × 106/kg (range 3.51 × 106–3.39 × 107/kg). Among patients with PGF who survived ≥ 3 months post-SCB (n = 8), we observed a non-significant decrease in the cumulative median number of red cell transfusions, platelet transfusions, and GCSF but not intravenous immunoglobulin doses in the 3 months before and after SCB. Overall response rate (ORR) was 50%, with 29% complete and 21% partial responses. ORR was better in recipients who received lymphodepletion (LD) pre-SCB versus none (75% versus 40%; p = 0.56). The incidence of acute and chronic graft-versus-host-disease was 7% and 14%, respectively. The 1-year OS was 50% (95% CI 23–72%) and TRM was 29% (95% CI 8–58%). SCB was effective in half of our cohort with possible benefit of LD pre-SCB.

Original languageEnglish (US)
Pages (from-to)155-164
Number of pages10
JournalClinical Hematology International
Issue number2-3
StatePublished - Jun 2023


  • CD34 stem cell boost
  • Outcomes
  • Pediatrics
  • Post stem cell transplant

ASJC Scopus subject areas

  • Hematology
  • Health Professions (miscellaneous)


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