TY - JOUR
T1 - Optimizing the CD34 + cell dose for reduced-intensity allogeneic hematopoietic stem cell transplantation
AU - Mehta, Jayesh
AU - Frankfurt, Olga
AU - Altman, Jessica
AU - Evens, Andrew
AU - Tallman, Martin
AU - Gordon, Leo
AU - Williams, Stephanie
AU - Winter, Jane
AU - Krishnamurthy, Jairam
AU - Duffey, Sara
AU - Singh, Veerpal
AU - Meagher, Richard
AU - Grinblatt, David
AU - Kaminer, Lynne
AU - Singhal, Seema
PY - 2009
Y1 - 2009
N2 - Low CD34 + cell doses increase allograft-related mortality and very high doses increase the risk of graft-versus-host disease. The optimum CD34 + cell dose remains undefined. The effect of the CD34 + cell dose based on ideal weight was analyzed in 130 patients with hematologic malignancies undergoing reduced-intensity allogeneic blood cell transplantation in the context of factors known to affect the outcome: chemosensitivity, donor age, lactate dehydrogenase (LDH), human leukocyte antigen (HLA) match, performance status, and platelet count. The survival of patients receiving >8 × - 10 6/kg CD34 + cells was not significantly different from those receiving <6. The outcome of those receiving 6 8 × - 106/kg CD34 + cells was significantly better than the rest. This superiority was confirmed in multivariable analysis. Among patients receiving ≤ 8 × - 106/kg CD34 + cells, an increasing number of infused cells was associated with higher overall survival in a continuous fashion (Risk ratio (RR) 0.8759; p = 0.045). Cell dose based on actual weight did not correlate with survival. The number of CD34 + cells infused, a potentially modifiable factor, affects survival after reduced-intensity allogeneic transplantation. We recommend a CD34 + cell dose of 6 8 × - 106 per kg ideal body weight to optimize outcome. The possible adverse effect of higher cell doses (>8) needs further confirmation.
AB - Low CD34 + cell doses increase allograft-related mortality and very high doses increase the risk of graft-versus-host disease. The optimum CD34 + cell dose remains undefined. The effect of the CD34 + cell dose based on ideal weight was analyzed in 130 patients with hematologic malignancies undergoing reduced-intensity allogeneic blood cell transplantation in the context of factors known to affect the outcome: chemosensitivity, donor age, lactate dehydrogenase (LDH), human leukocyte antigen (HLA) match, performance status, and platelet count. The survival of patients receiving >8 × - 10 6/kg CD34 + cells was not significantly different from those receiving <6. The outcome of those receiving 6 8 × - 106/kg CD34 + cells was significantly better than the rest. This superiority was confirmed in multivariable analysis. Among patients receiving ≤ 8 × - 106/kg CD34 + cells, an increasing number of infused cells was associated with higher overall survival in a continuous fashion (Risk ratio (RR) 0.8759; p = 0.045). Cell dose based on actual weight did not correlate with survival. The number of CD34 + cells infused, a potentially modifiable factor, affects survival after reduced-intensity allogeneic transplantation. We recommend a CD34 + cell dose of 6 8 × - 106 per kg ideal body weight to optimize outcome. The possible adverse effect of higher cell doses (>8) needs further confirmation.
KW - Allogeneic transplantation
KW - CD34 cell dose
KW - blood
KW - transplant-related mortality
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U2 - 10.1080/10428190903085944
DO - 10.1080/10428190903085944
M3 - Article
C2 - 19603344
AN - SCOPUS:78650226748
SN - 1042-8194
VL - 50
SP - 1434
EP - 1441
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 9
ER -