Decreased treatment failure in recipients of HLA-identical bone marrow or peripheral blood stem cell transplants with high CD34 cell doses
A. John Barrett
National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD,
Search for more papers by this authorMei-Jie Zhang
Graft-versus-host disease/graft-versus-leukaemia Working Committee of the International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI,
Search for more papers by this authorFausto R. Loberiza
Graft-versus-host disease/graft-versus-leukaemia Working Committee of the International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI,
Search for more papers by this authorBrian J. Bolwell
The Cleveland Clinic Foundation, Cleveland, OH,
Search for more papers by this authorRobert Peter Gale
Center for Advanced Studies in Leukaemia, Los Angeles, CA, 6 St Jude Children's Research Hospital, Memphis, TN,
Search for more papers by this authorGregory A. Hale
Center for Advanced Studies in Leukaemia, Los Angeles, CA, 6 St Jude Children's Research Hospital, Memphis, TN,
Search for more papers by this authorRodrigo Martino
Hospital de la Santa Creu I Sant Pau, Barcelona, Spain,
Search for more papers by this authorJames A. Russell
Tom Baker Cancer Centre, Calgary, Alta, Canada,
Search for more papers by this authorPierre Tiberghien
Etablissement de Transfusion Sangine de Franche-Comte, Besancon, France, and
Search for more papers by this authorMary M. Horowitz
Graft-versus-host disease/graft-versus-leukaemia Working Committee of the International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI,
Reprint requests: Mary M. Horowitz, MD, MS, Statistical Center, International Bone Marrow Transplant Registry, Medical College of Wisconsin, 8701 Watertown Plank Road, PO Box 26509, Milwaukee, Wisconsin, 53226, USA. E-mail: [email protected]
Search for more papers by this authorA. John Barrett
National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD,
Search for more papers by this authorMei-Jie Zhang
Graft-versus-host disease/graft-versus-leukaemia Working Committee of the International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI,
Search for more papers by this authorFausto R. Loberiza
Graft-versus-host disease/graft-versus-leukaemia Working Committee of the International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI,
Search for more papers by this authorBrian J. Bolwell
The Cleveland Clinic Foundation, Cleveland, OH,
Search for more papers by this authorRobert Peter Gale
Center for Advanced Studies in Leukaemia, Los Angeles, CA, 6 St Jude Children's Research Hospital, Memphis, TN,
Search for more papers by this authorGregory A. Hale
Center for Advanced Studies in Leukaemia, Los Angeles, CA, 6 St Jude Children's Research Hospital, Memphis, TN,
Search for more papers by this authorRodrigo Martino
Hospital de la Santa Creu I Sant Pau, Barcelona, Spain,
Search for more papers by this authorJames A. Russell
Tom Baker Cancer Centre, Calgary, Alta, Canada,
Search for more papers by this authorPierre Tiberghien
Etablissement de Transfusion Sangine de Franche-Comte, Besancon, France, and
Search for more papers by this authorMary M. Horowitz
Graft-versus-host disease/graft-versus-leukaemia Working Committee of the International Bone Marrow Transplant Registry, Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI,
Reprint requests: Mary M. Horowitz, MD, MS, Statistical Center, International Bone Marrow Transplant Registry, Medical College of Wisconsin, 8701 Watertown Plank Road, PO Box 26509, Milwaukee, Wisconsin, 53226, USA. E-mail: [email protected]
Search for more papers by this authorAbstract
Summary. We studied the association between CD34 cell dose and transplant outcomes in 359 bone marrow (BM) and 511 peripheral blood stem cell (PBSC) transplant recipients from human leucocyte antigen (HLA)-identical siblings, reported to the International Bone Marrow Transplant Registry (IBMTR). Transplants for leukaemia were performed between 1995 and 1998. Patients were divided into those receiving below or above the median CD34+ dose, for BM (3 × 106/kg) and PBSC (6 × 106/kg) grafts respectively. Cox proportional hazards regression was used to adjust for baseline patient-, disease- and transplant-related characteristics. Analysis of the BM recipients showed that high CD34 cell dose was associated with lower transplant-related mortality [relative risk (RR) = 0·60, P = 0·033] and treatment failure (inverse of leukaemia-free survival, RR = 0·69, P = 0·032). Among PBSC recipients, high CD34 dose was associated with faster recovery of neutrophils to > 0·5 × 109/l (RR = 1·38, P < 0·001) and platelets to > 20 × 109/l (RR = 1·34, P = 0·003), lower risk of relapse (RR = 0·62, P = 0·029) and treatment failure (RR = 0·74, P = 0·03). We conclude that higher CD34 cell doses decrease treatment failure in recipients of HLA-identical sibling BM and PBSC transplants.
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