Effect of CD34+ Cell Dose on the Outcomes of Allogeneic Stem Cell Transplantation with Post-Transplantation Cyclophosphamide
Pedraza, Alexandra (Hospital Clínic i Provincial de Barcelona)
Salas, María Queralt (Hospital Clínic i Provincial de Barcelona)
Rodríguez Lobato, Luis Gerardo (Hospital Clínic i Provincial de Barcelona)
Charry, Paola (Hospital Clínic i Provincial de Barcelona)
Suárez-Lledó Grande, María (Hospital Clínic i Provincial de Barcelona)
Martínez-Cibrian, Núria (Hospital Clínic i Provincial de Barcelona)
Doménech, Ariadna (Hospital Clínic i Provincial de Barcelona)
Solano, Maria Teresa (Hospital Clínic i Provincial de Barcelona)
Arcarons, Jordi (Hospital Clínic i Provincial de Barcelona)
de Llobet, Noemí (Hospital Clínic i Provincial de Barcelona)
Rosiñol, Laura (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Gutiérrez-García, Gonzalo (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Fernández Avilés, Francesc (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Urbano Ispizua, Álvaro (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Rovira, Montserrat (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Martínez, Carmen (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)

Date:	2023
Abstract:	The impact of infused CD34 cell dose on outcomes after allogeneic hematopoietic stem cell transplantation (alloHSCT) using standard graft-versus-host disease (GVHD) prophylaxis remains controversial. Information on this subject is scarce for alloHSCT using high-dose post-transplantation cyclophosphamide (PTCy). We aimed to assess the effect of CD34 cell dose in peripheral blood stem cell (PBSC) grafts on the outcome of alloHSCT using PTCy-based GVHD prophylaxis. To do so, we conducted a single-center retrospective analysis of 221 consecutive adult patients who underwent PTCy alloHSCT from HLA-matched sibling donors (MSDs; n = 22), HLA-matched unrelated donors (MUDs; n = 83), mismatched unrelated donors (MMUDs; n = 73), and haploidentical donors (n = 43). Based on the binary partitioning method, 5 × 10/kg was used as the optimal cutoff for CD34 cell dose. According to our institutional protocol, the maximum CD34 cell dose was capped at 8 × 10/kg. The study cohort was divided into 2 groups based on CD34 cell dose: high dose (>5 to 8 × 10/kg) and low dose (≤5 × 10/kg). Patients receiving high-dose CD34-containing grafts had significantly shorter median times to neutrophil engraftment and platelet engraftment compared to those who received low-dose CD34+ (19 days versus 21 days [P =. 002] and 16 days versus 22 days [P =. 04], respectively). There were no differences between the high-dose and low-dose groups in the cumulative incidence of day +100 acute GVHD (grade II-IV: 25% versus 23% [P =. 7]; grade III-IV: 5% versus 4% [P =. 4], respectively) or 2-year chronic GVHD (moderate/severe GVHD: 9% versus 6%; P =. 5). There was no impact of CD34 cell dose on survival outcomes with the use of MSDs, MUDs, or MMUDs. Recipients of haploidentical alloHSCT using low-dose CD34 cells had significantly worse overall survival (hazard ratio [HR], 6. 01; P =. 004) and relapse-free survival (HR, 4. 57; P =. 004). In recipients of PBSC PTCy alloHSCT, infused CD34 cell doses >5 to 8 × 10/kg were associated with faster neutrophil and platelet engraftment, independent of donor type. Our study suggests an impact of CD34 cell dose on survival outcomes only with haploidentical donors, for whom the administration of a CD34 cell dose ≤5 × 10/kg significantly decreased survival outcomes.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Transplantation and cellular therapy, Vol. 29 Núm. 3 (march 2023) , p. 181.e1-181.e10, ISSN 2666-6367

DOI: 10.1016/j.jtct.2022.12.005

10 p, 1.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Josep Carreras Leukaemia Research Institute
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