Allogeneic hematopoietic transplantation of CD34+ selected cells from an HLA haplo-identical related donor. A long-term follow-up of 135 patients and a comparison of stem cell source between the bone marrow and the peripheral blood

Bone Marrow Transplant. 2000 Dec;26(12):1281-90. doi: 10.1038/sj.bmt.1702707.

Abstract

We studied the outcome of allogeneic transplants in 135 patients who received selected BM and/or PBSC CD34+ cells from HLA haplo-identical related donors. Donor engraftment was achieved in 108 of 128 evaluable transplants. Engraftment failure occurred more often in non-malignant than in malignant diseases (10 of 25 vs 17 of 103, P = 0.010). The CD34+ cell dose was associated with the speed of neutrophil and platelet recovery, but the cell source was not. Acute GVHD (> or = grade II) developed in 21.0 +/- 3.7%. Chronic GVHD occurred more frequently in malignancies than in non-malignancies (44.1 +/- 7.6% vs 0.0%, P = 0.0075), and more in PBSC recipients than in BM recipients (53.6 +/- 9.4% vs 17.4 +/- 9.3%, P = 0.0054). Relapse rate was higher in high risk patients than in standard risk patients (78.7 +/- 7.1% vs 22.1 +/- 10.0%, P = 0.0001). Probabilities of disease-free survival (DFS) were 14.2 +/- 3.5% in malignancies and 25.7 +/- 9.2% in non-malignancies. Probabilities of DFS in standard and high risk patients were 39.4 +/- 9.2% and 5.7 +/- 2.8% (P = 0.0001). A high incidence of graft failure, infection and relapse was observed and resulted in high mortality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actuarial Analysis
  • Acute Disease
  • Antigens, CD34 / blood*
  • Blood Cells / immunology
  • Blood Cells / transplantation
  • Blood Donors
  • Bone Marrow Cells / immunology
  • Bone Marrow Transplantation
  • Follow-Up Studies
  • Graft Survival
  • Graft vs Host Disease / etiology
  • Haplotypes / immunology*
  • Hematopoietic Stem Cell Transplantation / methods
  • Hematopoietic Stem Cell Transplantation / mortality
  • Hematopoietic Stem Cell Transplantation / standards
  • Histocompatibility Testing
  • Humans
  • Transplantation, Homologous / methods*
  • Transplantation, Homologous / mortality
  • Transplantation, Homologous / standards
  • Treatment Outcome

Substances

  • Antigens, CD34