The impact of CD34⁺ cell dose on platelet engraftment in pediatric patients following unmanipulated haploidentical blood and marrow transplantation

Abstract

Our results suggest that low number of CD34+ cells in allografts is a critical factor associated with delayed platelet engraftment after unmanipulated haploidentical transplantation in pediatric patients.

Haploidentical Bone Marrow Transplantation Without T-Cell Depletion

“…10,15,16,18 -22,39,42-44 A higher CD34 ϩ cell dose is associated with faster platelet engraftment both in adult and pediatric patients after haploidentical transplant without in vivo T-cell depletion. 15,43 Using their unmanipulated haploidentical blood and marrow transplant protocol, the Peking University group found that a higher dose of CD4 ϩ CD45RA ϩ CD62L ϩ or CD56 bright NK cells correlated with an increased incidence of grades II-IV acute GVHD while, conversely, a lower dose of CD4 ϩ CD25 high CD45RA ϩ CD62L ϩ T cells in the allografts was associated with a higher incidence of grades II-IV acute GVHD. 21,44 Other factors, including a lower CD56 dim /CD56 bright NK cell ratio (Ͻ8.0) and a higher CD4/CD8 ratio (Ͼ1.16) in the allografts, may contribute not only to higher risk of acute GVHD but also to increased TRM and decreased OS.…”

Immune reconstitution in patients with acquired severe aplastic anemia after haploidentical stem cell transplantation

“…17,18 Myeloid and platelet engraftment were defined according to previous reports. 19 The diagnosis and grading of acute and chronic GVHD were assigned by the transplant center according to the standard criteria. 20,21…”

The cell composition of infused donor lymphocyte has different impact in different types of allogeneic hematopoietic stem cell transplantation

“…However, the exact role of DLI cell composition in these outcomes is unclear. Previous research has demonstrated the predictive value of allograft components in allo‐HSCT . These data led us to hypothesize that mDLI cell composition might impact a patient's prognosis.…”

“…In our previous work, we investigated the impact of graft composition on the clinical outcomes of both adult and pediatric patients with unmanipulated haploidentical HSCT. The distinct influences of CD34 + cells in grafts and the CD4/CD8 ratio in G‐CSF primed bone marrow (BM) on patient prognosis have been previously demonstrated . In contrast, it is unknown whether the cell components of mDLI play similar roles in transplants or whether mDLI composition produces differential effects in multiple types of HSCT, such as human leukoctye antigen (HLA)‐identical and haploidentical transplants.…”