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Outcome of transplantation of highly purified peripheral blood CD34+ cells with T-cell add-back compared with unmanipulated bone marrow or peripheral blood stem cells from HLA-identical sibling donors in patients with first chronic phase chronic myeloid leukemia.
Blood. 2003 Jan 15; 101(2):446-53.Blood

Abstract

Outcomes of highly purified CD34(+) peripheral blood stem cell transplantation (PBSCT) for chronic phase chronic myeloid leukemia (CML) (n = 32) were compared with those of PBSCT (n = 19) and of bone marrow transplantation (BMT) (n = 22) in the HLA-compatible sibling donor setting. Median follow-up was 18 months after CD34(+)-PBSCT and unmanipulated PBSCT and 20 months after BMT. CD34(+)-PBSCT was associated with delayed T-cell immune reconstitution at 3 months and 12 months after transplantation compared with PBSCT (P <.001) or BMT (not significant [NS]). The estimated probability of grades II to IV acute graft-versus-host disease (GVHD) was 60% +/- 13% for the PBSCT group, 37% +/- 13% for the BMT group, and only 14% +/- 8% for the CD34(+)-PBSCT group (CD34-PBSCT versus BMT, P <.01; and CD34-PBSCT versus PBSCT, P <.001). The probabilities for molecular relapse were 88% for CD34(+)-PBSCT, 55% after BMT, and 37% after PBSCT (CD34(+)-PBSCT versus PBSCT, P <.03). Cytogenetic relapse probability was 58% after CD34(+)-PBSCT, 42% after BMT, and 28% after PBSCT (NS). After CD34(+)-PBSCT, 26 of 32 patients received a T-cell add-back. Hematologic relapse occurred in 4 of 22 patients after BMT, in 3 of 19 patients after PBSCT, and in only 1 of 32 patients after CD34(+)-PBSCT. The occurrence of a hematologic relapse in patients receiving CD34(+)-PBSC transplants was prevented by donor leukocyte infusions, which were applied at a median of 4 times (range, 1-7 times) with a median T-cell dose of 3.3 x 10(6) x kg/body weight [at a median] beginning at day 120 (range, 60-690 days). The estimated probability of 3-year survival after transplantation was 90% in the CD34(+)-PBSCT group, 68% in the PBSCT group, and 63% in the BMT group (CD34-PBSCT versus BMT, P <.01; and CD34-PBSCT versus PBSCT, P <.03). Transplantation of CD34(+)-PBSCs with T-cell add-back for patients with CML in first chronic phase seems to be safe and is an encouraging alternative transplant procedure to BMT or PBSCT.

Authors+Show Affiliations

Department of Bone Marrow Transplantation and the Institute of Immunology, University Hospital of Essen, Germany. ahmet.elmaagacli@uni-essen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12393406

Citation

Elmaagacli, Ahmet H., et al. "Outcome of Transplantation of Highly Purified Peripheral Blood CD34+ Cells With T-cell Add-back Compared With Unmanipulated Bone Marrow or Peripheral Blood Stem Cells From HLA-identical Sibling Donors in Patients With First Chronic Phase Chronic Myeloid Leukemia." Blood, vol. 101, no. 2, 2003, pp. 446-53.
Elmaagacli AH, Peceny R, Steckel N, et al. Outcome of transplantation of highly purified peripheral blood CD34+ cells with T-cell add-back compared with unmanipulated bone marrow or peripheral blood stem cells from HLA-identical sibling donors in patients with first chronic phase chronic myeloid leukemia. Blood. 2003;101(2):446-53.
Elmaagacli, A. H., Peceny, R., Steckel, N., Trenschel, R., Ottinger, H., Grosse-Wilde, H., Schaefer, U. W., & Beelen, D. W. (2003). Outcome of transplantation of highly purified peripheral blood CD34+ cells with T-cell add-back compared with unmanipulated bone marrow or peripheral blood stem cells from HLA-identical sibling donors in patients with first chronic phase chronic myeloid leukemia. Blood, 101(2), 446-53.
Elmaagacli AH, et al. Outcome of Transplantation of Highly Purified Peripheral Blood CD34+ Cells With T-cell Add-back Compared With Unmanipulated Bone Marrow or Peripheral Blood Stem Cells From HLA-identical Sibling Donors in Patients With First Chronic Phase Chronic Myeloid Leukemia. Blood. 2003 Jan 15;101(2):446-53. PubMed PMID: 12393406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of transplantation of highly purified peripheral blood CD34+ cells with T-cell add-back compared with unmanipulated bone marrow or peripheral blood stem cells from HLA-identical sibling donors in patients with first chronic phase chronic myeloid leukemia. AU - Elmaagacli,Ahmet H, AU - Peceny,Rudolf, AU - Steckel,Nina, AU - Trenschel,Rudolf, AU - Ottinger,Hellmut, AU - Grosse-Wilde,Hans, AU - Schaefer,Ulrich W, AU - Beelen,Dietrich W, Y1 - 2002/09/12/ PY - 2002/10/24/pubmed PY - 2003/4/9/medline PY - 2002/10/24/entrez SP - 446 EP - 53 JF - Blood JO - Blood VL - 101 IS - 2 N2 - Outcomes of highly purified CD34(+) peripheral blood stem cell transplantation (PBSCT) for chronic phase chronic myeloid leukemia (CML) (n = 32) were compared with those of PBSCT (n = 19) and of bone marrow transplantation (BMT) (n = 22) in the HLA-compatible sibling donor setting. Median follow-up was 18 months after CD34(+)-PBSCT and unmanipulated PBSCT and 20 months after BMT. CD34(+)-PBSCT was associated with delayed T-cell immune reconstitution at 3 months and 12 months after transplantation compared with PBSCT (P <.001) or BMT (not significant [NS]). The estimated probability of grades II to IV acute graft-versus-host disease (GVHD) was 60% +/- 13% for the PBSCT group, 37% +/- 13% for the BMT group, and only 14% +/- 8% for the CD34(+)-PBSCT group (CD34-PBSCT versus BMT, P <.01; and CD34-PBSCT versus PBSCT, P <.001). The probabilities for molecular relapse were 88% for CD34(+)-PBSCT, 55% after BMT, and 37% after PBSCT (CD34(+)-PBSCT versus PBSCT, P <.03). Cytogenetic relapse probability was 58% after CD34(+)-PBSCT, 42% after BMT, and 28% after PBSCT (NS). After CD34(+)-PBSCT, 26 of 32 patients received a T-cell add-back. Hematologic relapse occurred in 4 of 22 patients after BMT, in 3 of 19 patients after PBSCT, and in only 1 of 32 patients after CD34(+)-PBSCT. The occurrence of a hematologic relapse in patients receiving CD34(+)-PBSC transplants was prevented by donor leukocyte infusions, which were applied at a median of 4 times (range, 1-7 times) with a median T-cell dose of 3.3 x 10(6) x kg/body weight [at a median] beginning at day 120 (range, 60-690 days). The estimated probability of 3-year survival after transplantation was 90% in the CD34(+)-PBSCT group, 68% in the PBSCT group, and 63% in the BMT group (CD34-PBSCT versus BMT, P <.01; and CD34-PBSCT versus PBSCT, P <.03). Transplantation of CD34(+)-PBSCs with T-cell add-back for patients with CML in first chronic phase seems to be safe and is an encouraging alternative transplant procedure to BMT or PBSCT. SN - 0006-4971 UR - https://www.unboundmedicine.com/medline/citation/12393406/Outcome_of_transplantation_of_highly_purified_peripheral_blood_CD34+_cells_with_T_cell_add_back_compared_with_unmanipulated_bone_marrow_or_peripheral_blood_stem_cells_from_HLA_identical_sibling_donors_in_patients_with_first_chronic_phase_chronic_myeloid_leukemia_ L2 - https://ashpublications.org/blood/article-lookup/doi/10.1182/blood-2002-05-1615 DB - PRIME DP - Unbound Medicine ER -