Donor, recipient, and transplant characteristics as risk factors after unrelated donor PBSC transplantation: beneficial effects of higher CD34+ cell dose
Year: 2009
Type: article
Abstract: We report outcomes of 932 recipients of unrelated donor peripheral blood stem cell hematopoietic cell transplantation (URD-PBSC HCT) for acute myeloid leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome enrolled on a prospective National Marrow Donor Program trial from 1999 through 2003. Preparative regimens included myeloablative (MA; N = 611), reduced-intensity (RI; N = 160), and nonmyeloablative (NMA; N = 161). For MA recipients, CD34(+) counts greater than 3.8 x 10(6)/kg improved neutrophil and platelet engraftment, whereas improved overall survival (OS) and reduced transplant-related mortality (TRM) were seen for all preparative regimens when CD34(+) cell doses exceeded 4.5 x 10(6)/kg. Higher infused doses of CD34(+) cell dose did not result in increased rates of either acute or chronic graft-versus-host disease (GVHD). Three-year OS and disease-free survival (DFS) of recipients of MA, RI, and NMA approaches were similar (33%, 35%, and 32% OS; 33%, 30%, and 29% DFS, respectively). In summary, recipients of URD-PBSC HCT receiving preparative regimens differing in intensity experienced similar survival. Higher CD34(+) cell doses resulted in more rapid engraftment, less TRM, and better 3-year OS (39% versus 25%, MA, P = .004; 38% versus 21% RI/NMA, P = .004) but did not increase the risk of GVHD. This trial was registered at www.clinicaltrials.gov as #NCT00785525.
Source: Blood
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Defense, U.S. Department of Health and Human Services, Abbott Laboratories, Amgen, Bristol-Myers Squibb, Pfizer, Astellas Pharma US, GlaxoSmithKline, Sanofi, WellPoint, Baxter International, American International Group, Biogen, Celgene, Enzon Pharmaceuticals, HistoGenetics, Osiris Therapeutics, Therakos, StemCyte, Medical College of Wisconsin, Leuka, CellGenix, IC Design Education Center, Astellas Pharma, Health Resources and Services Administration, U.S. Public Health Service, U.S. Navy, Takeda Oncology, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
OpenAlex ID: W2076267122