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Allogeneic transplantation of selected CD34+ cells from peripheral blood: experience of 62 cases using immunoadsorption or immunomagnetic technique. Spanish Group of Allo-PBT.
Bone Marrow Transplant. 1998 Sep; 22(6):519-25.BM

Abstract

The objective of this study was to analyze CD34+ cell recovery and T cell depletion (TCD) achieved in CD34+ cell grafts using either immunoadsorption or immunomagnetic methods applied to leukapheresis products from healthy donors. We also wanted to determine the kinetics of engraftment and incidence and severity of graft-versus-host disease (GVHD) after allogeneic transplantation of selected CD34+ cells. HLA-identical sibling donors received G-CSF. After leukapheresis, peripheral blood progenitor cells were selected using immunoadsorption (Ceprate SC) (n = 38) or immunomagnetic (Isolex 300) (n = 24) methods. Sixty-two patients, with a median age of 42 years (range 17-60) diagnosed with hematological malignancies were conditioned with either cyclophosphamide and total body irradiation (n = 43) or busulphan and cyclophosphamide (n = 19). GVHD prophylaxis consisted of cyclosporin A (CsA) and prednisone (n = 48), CsA alone (n = 11) and CsA and methotrexate (n = 3). The median yield and purity of CD34+ cells after the procedure was 65 and 66% with immunoadsorption, and 48 and 86% with immunomagnetic method, respectively. The median number (range) of CD34+ cells infused into the patients was 3.5 x 10(6)/kg (1-9.6). The median number (range) of CD3+ cells administered was 0.4 x 10(6)/kg (0.01-2) using immunoadsorption and 0.14 x 10(6)/kg (0.03-2.5) using immunomagnetic methods. Neutrophil recovery >500 and >1000/microl was achieved at a median (range) of 13 days (8-22) and 14 days (9-31), respectively. Platelets recovered to >20000 and >50000/microl at a median (range) of 13 days (0-128) and 18 days (0-180), respectively. Two patients developed graft failure. Acute GVHD in patients at risk was clinical grade 0 (n = 43), I (n = 8), II (n = 4) and III (n = 1). No patient developed acute GVHD grade IV. Chronic GVHD was limited in two cases and extensive in four cases. The actuarial probability of acute GVHD II-IV was 10% (95% CI, 1-19%), and of extensive chronic GVHD was 12% (95% CI, 11-13%). The cumulative incidence of transplant-related mortality was 12.6%, and this figure was 9% at 6 months. In conclusion, with the immunomagnetic procedure, a lower recovery and higher purity of CD34+ cells, and stronger TCD is obtained as compared to immunoadsorption (P = 0.008, P < 0.0001 and P = 0.0002, respectively). Our results also indicate that allogeneic transplantation of selected CD34+ cells is associated with a very rapid engraftment and with a low incidence of severe GVHD.

Authors

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Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9758337

Citation

Urbano-Ispizua, A, et al. "Allogeneic Transplantation of Selected CD34+ Cells From Peripheral Blood: Experience of 62 Cases Using Immunoadsorption or Immunomagnetic Technique. Spanish Group of Allo-PBT." Bone Marrow Transplantation, vol. 22, no. 6, 1998, pp. 519-25.
Urbano-Ispizua A, Solano C, Brunet S, et al. Allogeneic transplantation of selected CD34+ cells from peripheral blood: experience of 62 cases using immunoadsorption or immunomagnetic technique. Spanish Group of Allo-PBT. Bone Marrow Transplant. 1998;22(6):519-25.
Urbano-Ispizua, A., Solano, C., Brunet, S., de la Rubia, J., Odriozola, J., Zuazu, J., Figuera, A., Caballero, D., Martínez, C., García, J., Sanz, G., Torrabadella, M., Alegre, A., Pérez-Oteiza, J., Jurado, M., Oyonarte, S., Sierra, J., García-Conde, J., & Rozman, C. (1998). Allogeneic transplantation of selected CD34+ cells from peripheral blood: experience of 62 cases using immunoadsorption or immunomagnetic technique. Spanish Group of Allo-PBT. Bone Marrow Transplantation, 22(6), 519-25.
Urbano-Ispizua A, et al. Allogeneic Transplantation of Selected CD34+ Cells From Peripheral Blood: Experience of 62 Cases Using Immunoadsorption or Immunomagnetic Technique. Spanish Group of Allo-PBT. Bone Marrow Transplant. 1998;22(6):519-25. PubMed PMID: 9758337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allogeneic transplantation of selected CD34+ cells from peripheral blood: experience of 62 cases using immunoadsorption or immunomagnetic technique. Spanish Group of Allo-PBT. AU - Urbano-Ispizua,A, AU - Solano,C, AU - Brunet,S, AU - de la Rubia,J, AU - Odriozola,J, AU - Zuazu,J, AU - Figuera,A, AU - Caballero,D, AU - Martínez,C, AU - García,J, AU - Sanz,G, AU - Torrabadella,M, AU - Alegre,A, AU - Pérez-Oteiza,J, AU - Jurado,M, AU - Oyonarte,S, AU - Sierra,J, AU - García-Conde,J, AU - Rozman,C, PY - 1998/10/3/pubmed PY - 1998/10/3/medline PY - 1998/10/3/entrez SP - 519 EP - 25 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 22 IS - 6 N2 - The objective of this study was to analyze CD34+ cell recovery and T cell depletion (TCD) achieved in CD34+ cell grafts using either immunoadsorption or immunomagnetic methods applied to leukapheresis products from healthy donors. We also wanted to determine the kinetics of engraftment and incidence and severity of graft-versus-host disease (GVHD) after allogeneic transplantation of selected CD34+ cells. HLA-identical sibling donors received G-CSF. After leukapheresis, peripheral blood progenitor cells were selected using immunoadsorption (Ceprate SC) (n = 38) or immunomagnetic (Isolex 300) (n = 24) methods. Sixty-two patients, with a median age of 42 years (range 17-60) diagnosed with hematological malignancies were conditioned with either cyclophosphamide and total body irradiation (n = 43) or busulphan and cyclophosphamide (n = 19). GVHD prophylaxis consisted of cyclosporin A (CsA) and prednisone (n = 48), CsA alone (n = 11) and CsA and methotrexate (n = 3). The median yield and purity of CD34+ cells after the procedure was 65 and 66% with immunoadsorption, and 48 and 86% with immunomagnetic method, respectively. The median number (range) of CD34+ cells infused into the patients was 3.5 x 10(6)/kg (1-9.6). The median number (range) of CD3+ cells administered was 0.4 x 10(6)/kg (0.01-2) using immunoadsorption and 0.14 x 10(6)/kg (0.03-2.5) using immunomagnetic methods. Neutrophil recovery >500 and >1000/microl was achieved at a median (range) of 13 days (8-22) and 14 days (9-31), respectively. Platelets recovered to >20000 and >50000/microl at a median (range) of 13 days (0-128) and 18 days (0-180), respectively. Two patients developed graft failure. Acute GVHD in patients at risk was clinical grade 0 (n = 43), I (n = 8), II (n = 4) and III (n = 1). No patient developed acute GVHD grade IV. Chronic GVHD was limited in two cases and extensive in four cases. The actuarial probability of acute GVHD II-IV was 10% (95% CI, 1-19%), and of extensive chronic GVHD was 12% (95% CI, 11-13%). The cumulative incidence of transplant-related mortality was 12.6%, and this figure was 9% at 6 months. In conclusion, with the immunomagnetic procedure, a lower recovery and higher purity of CD34+ cells, and stronger TCD is obtained as compared to immunoadsorption (P = 0.008, P < 0.0001 and P = 0.0002, respectively). Our results also indicate that allogeneic transplantation of selected CD34+ cells is associated with a very rapid engraftment and with a low incidence of severe GVHD. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/9758337/Allogeneic_transplantation_of_selected_CD34+_cells_from_peripheral_blood:_experience_of_62_cases_using_immunoadsorption_or_immunomagnetic_technique__Spanish_Group_of_Allo_PBT_ L2 - http://dx.doi.org/10.1038/sj.bmt.1701386 DB - PRIME DP - Unbound Medicine ER -