Allogeneic Transplantation with CD34+-Selected Cells

Abstract

We report the outcome of eight patients with different hematological malignancies who were transplanted with allogeneic CD34-selected mononuclear cells following myeloablative therapy. Four patients received G-CSF mobilized CD34-enriched peripheral blood progenitor cells (PBPC) together with CD34-enriched bone marrow (BM), two patients were transplanted with allogeneic G-CSF mobilized CD34-enriched PBPC alone, and two patients received only allogeneic CD34-enriched BM cells. On average, patients received 2.66 ± 106 CD34+-cells/kg BW (range: 0.53–8.40 ± 106 CD34+-cells/kg body weight) and 0.57 ± 106 CD3+-cells/kg BW (range: 0.20–1.10 ± 106 CD3+-cells/kg BW), respectively. Seven of the eight patients engrafted (ANC > 0.5 ± 109/L median: day +19 (range: 16–23 days); platelets > 20 ± 109/L median: day +34 (range: 21–47 days); one patient died on day + 16 after transplantation and was not evaluable for engraftment. Three of seven patients evaluable for acute graft-versus-host disease (GvHD) developed acute GvHD grade II which resolved upon steroid treatment. Five of the eight patients are still alive and in remission with a median follow-up of 215 days (range: 80–420 days). Causes of death included fungal infection, cerebral bleeding and sepsis. These preliminary data suggest that CD34-enriched cells can be successfully given during for allogenic transplantation following myeloablative therapy in hematological malignancies. The impact of T-cell depletion by enrichment for CD34+-cells in an attempt to reducing the incidence and/or severity of acute and/or chronic GvHD still remains to be determined.