Impact of CD34 subsets on engraftment kinetics in allogeneic peripheral blood stem cell transplantation

Abstract

Summary:Our objective was to evaluate, probably for the first time, the impact of CD34 subsets on engraftment kinetics in allogeneic PBSC transplantation (PBSCT). PBSC graft components were analyzed in 62 cases for the absolute count/kg of total CD34 þ and the following subsets: DRÀ and þ , CD71 þ /À, CD38þ /À, CD33þ /À and CD61 þ /À. Time to ANC 40.5 and 41 Â 10 9 /l and platelets 420 and 450 Â 10 9 /l was reported. The median value for each parameter was used to discriminate rapid from slow engraftment. Four parameters showed significant predictive power of early neutrophil engraftment, namely CD34 þ / DRÀ (P ¼ 0.002), CD34 þ /38À (P ¼ 0.02), CD34 þ / CD61À (P ¼ 0.04) and total CD34 þ cell dose (P ¼ 0.04). Four parameters showed significant predictive power of early platelet engraftment, namely CD34 þ /CD61 þ (P ¼ 0.02), CD34 þ /CD38À and total CD34 þ cell dose (P ¼ 0.04) and CD34 þ /CD71À (P ¼ 0.05). Comparing patients who received 4to those who received o the threshold dose(s), only CD34 þ /CD38À lost its significance for neutrophil engraftment; and only CD34 þ /CD61 þ retained its significance for platelet engraftment (P ¼ 0.03); furthermore, the former group required significantly fewer platelet transfusions (P ¼ 0.018). We concluded that in allogeneic PBSCT, the best predictor of early neutrophil engraftment is the absolute CD34 þ /DRÀ and for early platelet engraftment is the absolute CD34 þ /CD61 þ cell dose.

Multi-color immune-phenotyping of CD34 subsets reveals unexpected differences between various stem cell sources

“…We have thus reenacted and translated into clinical routine application what the above authors described in their extensive functional analyses, and we show that the composition of the CD34 subsets differs substantially between the three CD34 sources examined. We assume that routine application of the presented protocol will allow high from medium or poor quality transplant materials to be distinguished and may thus predict engraftment characteristics as addressed by several authors, [6][7][8]15,24 but this will have to be proven in future studies. The present results show clearly that PBSC contain significantly higher proportions of MPP, LMPP and EMP than BMd.…”

“…Their median age was 10 years (range 0. [8][9][10][11][12][13][14][15][16][17][18]. Conditioning regimens were myeloablative (n = 11) and reduced intensity (n = 10).…”

“…13,14 Some studies correlated the co-expression of CD38 and CD71 with neutrophil and platelet recovery. 6,15 CD133/Prominin-1 was included only recently into a panel of markers to define different CD34 subsets. 16 Based on these studies, Görgens et al 17 suggested a revision of the most recent model of human hematopoiesis, the composite model (Figure 1), originally proposed by the Jacobsen group.…”

The role of plerixafor in optimizing peripheral blood stem cell mobilization for autologous stem cell transplantation

“…This may be influenced not only by the total CD34 þ cell dose but also by levels of CD34 þ cell subsets, which influence neutrophil or platelet engraftment. 45,46 It has been suggested that the more primitive HSCs mobilized by plerixafor in combination with G-CSF may have a greater capacity for reconstituting bone marrow compared with those mobilized by G-CSF alone. 47 In conclusion, the availability of plerixafor is a significant advance, increasing the number of patients for whom auto-HSC transplantation is a potentially effective treatment option and increasing the number of patients able to proceed, in as short a time as possible, to high-dose chemotherapy.…”

Characterization of hemopoietic engraftment kinetics and development of secondary cytopenia in AML post auto-SCT and its correlation with survival outcome

“…26,28 Although the phenomenon has been well described among allogeneic transplant patients, very few reports are available in the literature for autologous transplant patients, more so in AML patients. 37,38 The few studies that have reported their observations on the effect of secondary thrombocytopenia on patients' survival and outcome in AML post-autologous transplantation had small numbers of AML patients in their study groups. A significant proportion of our patients (n ¼ 30, 35.7%) developed a secondary decline in plt counts post transplantation.…”