CD34+ selected stem cell boosts can improve poor graft function after paediatric allogeneic stem cell transplantation

• Verfasst von: Mainardi, Chiara [VerfasserIn]
• Verfasst von: Greil, Johann [VerfasserIn]
• Titel: CD34+ selected stem cell boosts can improve poor graft function after paediatric allogeneic stem cell transplantation
• Verf.angabe: Chiara Mainardi, Martin Ebinger, Sigrid Enkel, Tobias Feuchtinger, Heiko-Manuel Teltschik, Matthias Eyrich, Michael Schumm, Armin Rabsteyn, Patrick Schlegel, Christian Seitz, Carl-Phillip Schwarze, Ingo Müller, Johann Greil, Peter Bader, Paul-Gerhardt Schlegel, David Martin, Ursula Holzer, Michaela Döring, Rupert Handgretinger, Peter Lang
• Jahr: 2018
• Jahr des Originals: 2017
• Umfang: 10 S.
• Fussnoten: First published 03 December 2017 ; Das +-Zeichen ist im Titel hochgestellt ; Gesehen am 21.08.2018
• Titel Quelle: Enthalten in: British journal of haematology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1955
• Jahr Quelle: 2018
• Band/Heft Quelle: 180(2018), 1, Seite 90-99
• ISSN Quelle: 1365-2141
• DOI: doi:10.1111/bjh.15012
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: haematopoietic recovery
• Sach-SW: haematopoietic stem cell transplantation
• Sach-SW: poor graft function
• Sach-SW: stem cell boost
• K10plus-PPN: 1580247083

Abstract

Poor graft function (PGF) is a severe complication of haematopoietic stem cell transplantation (HSCT) and administration of donor stem cell boosts (SCBs) represents a therapeutic option. We report 50 paediatric patients with PGF who received 61 boosts with CD34+ selected peripheral blood stem cells (PBSC) after transplantation from matched unrelated (n = 25) or mismatched related (n = 25) donors. Within 8 weeks, a significant increase in median neutrophil counts (0·6 vs. 1·516 × 109/l, P < 0·05) and a decrease in red blood cell and platelet transfusion requirement (median frequencies 1 and 7 vs. 0, P < 0·0001 and <0·001), were observed, and 78·8% of patients resolved one or two of their cytopenias. 36·5% had a complete haematological response. Median lymphocyte counts for CD3+, CD3+CD4+, CD19+ and CD56+ increased 8·3-, 14·2-, 22.- and 1·6-fold. The rate of de novo acute graft-versus-host disease (GvHD) grade I-III was only 6% and resolved completely. No GvHD grade IV or chronic GvHD occurred. Patients who responded to SCB displayed a trend toward better overall survival (OS) (P = 0·07). Thus, administration of CD34+ selected SCBs from alternative donors is safe and effective. Further studies are warranted to clarify the impact on immune reconstitution and survival.