CD34 -selected stem cell “Boost” for poor graft function after allogeneic hematopoietic stem cell transplantation

Mohty, Razan; Brissot, Éolia; Battipaglia, Giorgia; Ruggeri, Annalisa; Sestili, Simona; Médiavilla, Clémence; Belhocine, Ramdane; Duléry, Rémy; Mohty, Mohamad; Malard, F.

doi:10.1016/j.retram.2018.12.003

Cited by 21 publications

(23 citation statements)

References 7 publications

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“…In contrast to PGF, graft rejection is defined as mixed chimerism or complete recipient chimerism, and it was excluded in patients with PGF. Other potential causes of pancytopenia after allo-HSCT, such as active infectious diseases or drug-induced myelosuppression, were excluded as well [3]. In concordance with graft rejection having a very poor prognosis [4], PGF has a high mortality rate due to infection and bleeding, especially in those patients who never achieve initial engraftment (primary PGF).…”

Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors, and Outcomes of Primary Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation

Zhao

Gao

Shi

et al. 2019

Biology of Blood and Marrow Transplantation

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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for both malignant and nonmalignant hematologic disorders. However, primary poor graft function (PGF) is a serious early complication of allo-HSCT that leads to a poor outcome. Little is known about the characteristics, incidence, and risk factors of primary PGF occurring after allo-HSCT. Here we performed a 1:4 ratio nested case-control study in 830 patients who underwent allo-HSCT between April 2013 and November 2018 at our center. Twenty-four patients (14 males and 10 females; average age, 35.79 years; range, 17 to 53 years) developed primary PGF. On univariate and multivariate analyses, a CD34 + cell dose <5 £ 10 6 /kg (P = .003), a serum ferritin (SF) level >2000 ng/mL (P = .008), and splenomegaly (P = .039) were identified as 3 independent risk factors for primary PGF. After a median follow-up of 7.5 months (range, 1 to 48 months), only 5 patients (20.8%) survived. The survival rate of patients with primary PGF was significantly lower than that of patients with good graft function (GGF) (1-year overall survival, 25.0% versus 90.6%; P < .001). Cox regression analysis suggested that PGF and high SF level were strongly associated with rapid death in these patients. In conclusion, allo-HSCT recipients with a low CD34 + cell dose in their graft and exhibiting a high SF level and splenomegaly should be monitored for the development of primary PGF after allo-HSCT, and effective therapies need to be explored.

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Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors, and Outcomes of Primary Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation

Zhao

Gao

Shi

et al. 2019

Biology of Blood and Marrow Transplantation

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“…Trilineage recovery was seen in 40%, 36%, and 75% of the patients, respectively. Subsequent studies confirmed their results that 70%–80% of patients with PGF showed trilineage recovery within 2 months after the infusion of CD34‐selected cells 12,17 . From these results, the current treatment option for PGF is a boost of CD34‐selected cells without conditioning.…”

Section: Discussionmentioning

confidence: 74%

“…Subsequent studies confirmed their results that 70%-80% of patients with PGF showed trilineage recovery within 2 months after the infusion of CD34-selected cells. 12,17 From these results, the current treatment option for PGF is a boost of CD34-selected cells without conditioning. Unfortunately, these cells have not been available in our hospital.…”

Section: F I G U R Ementioning

confidence: 99%

Risk factors for secondary poor graft function after bone marrow transplantation in children with acquired aplastic anemia

Hama

Muramatsu

Narita

et al. 2020

Pediatric Transplantation

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In patients with acquired AA, PGF is a major cause of cytopenia after HCT and classified into primary and sPGF. It is defined as the persistence of at least bilinear cytopenia with full donor chimerism in the absence of disease relapse and severe acute or chronic GVHD. 1 In addition, it should be distinguished from graft failure where the chimerism has a recipient origin or is mixed. The incidence of sPGF ranges from 5% to 27% and is associated with a high mortality of severe infections or bleeding. 1-5

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“…

Poor graft function (PGF) is a relatively common complication of hematopoietic stem cell transplantation (HSCT), with an incidence of 5% to 27% depending on the series. [1][2][3][4][5] PGF is characterized by peripheral cytopenia affecting two or three hematopoietic lineages associated with decreased bone marrow cellularity and complete donor chimerism (>95%).Factors associated with PGF are diverse: underlying disease and disease status at the time of transplant, donor type, HLA antibodies against HLA donor antigens, graft cell content, post-HSCT infections, myelotoxic drugs, graft-vs-host disease (GVHD), iron overload and splenomegaly. 1,6 There are few treatments available.

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mentioning

confidence: 99%

“…1,6 There are few treatments available. 5 Current options include blood transfusions, use of G-CSF, CD34 + -selected stem cell boosts (SCB) infusions, 2,5 and in experimental settings, mesenchymal cells…”

mentioning

confidence: 99%

Use of eltrombopag for the treatment of poor graft function after hematopoietic stem cell transplantation in children

Uria-Oficialdegui

Alonso

Benítez‐Carabante

et al. 2021

Pediatric Transplantation

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CD34 -selected stem cell “Boost” for poor graft function after allogeneic hematopoietic stem cell transplantation

Cited by 21 publications

References 7 publications

Incidence, Risk Factors, and Outcomes of Primary Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation

Incidence, Risk Factors, and Outcomes of Primary Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation

Risk factors for secondary poor graft function after bone marrow transplantation in children with acquired aplastic anemia

Use of eltrombopag for the treatment of poor graft function after hematopoietic stem cell transplantation in children

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