High-dose therapy in patients with Hodgkin's disease: the use of selected CD34+ cells is as safe as unmanipulated peripheral blood progenitor cells

Autor: Erlend B. Smeland, Stein Kvaløy, Jan Delabie, Gunnar Kvalheim, A. K. Blystad, Harald Holte
Rok vydání: 2001
Předmět:
Male
Transplantation Conditioning
autologous stem cell transplantation
medicine.medical_treatment
CD34
Antigens
CD34
Gastroenterology
Dexamethasone
Antineoplastic Combined Chemotherapy Protocols
Medicine
CD34+ cell enrichment
Melphalan
Etoposide
Graft Survival
Cytarabine
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Combined Modality Therapy
Hodgkin Disease
Hematopoietic Stem Cell Mobilization
Survival Rate
Haematopoiesis
Treatment Outcome
medicine.anatomical_structure
Female
Safety
Stem cell
Adult
Risk
medicine.medical_specialty
Neutropenia
Adolescent
Infections
Article
Internal medicine
Humans
Progenitor cell
Cyclophosphamide
Survival rate
Retrospective Studies
Salvage Therapy
Transplantation
Chemotherapy
business.industry
Carmustine
Survival Analysis
Immunology
Feasibility Studies
Radiotherapy
Adjuvant
Hodgkin's disease
Bone marrow
business
Follow-Up Studies
Zdroj: Bone Marrow Transplantation
ISSN: 1476-5365
0268-3369
DOI: 10.1038/sj.bmt.1703244
Popis: Register data suggest that patients with Hodgkin's disease (HD) given high-dose therapy (HDT) with peripheral blood progenitor cells (PBPC) have a less favourable prognosis as compared to those given bone marrow as stem cell support. Since this can be due to infusion of tumour cells contaminating the PBPC grafts, we initiated a feasibility study in which PBPC grafts from HD patients were purged by CD34+ cell enrichment. Controversy exists about whether the use of CD34+ enriched stem cells leads to a delayed haematological and immune reconstitution. We compared these parameters, including risk of infections and clinical outcome after HDT, in patients with HD given either selected CD34+ cells or unmanipulated PBPC as stem cell support. From October 1994 to May 2000, 40 HD patients with primary refractory disease or relapse were treated with HDT and supported with either selected CD34+ cells (n = 21) or unmanipulated PBPC (n = 19) as stem cell support. All patients had chemosensitive disease at the time of transplantation. A median of 5.8 (range 2.7–20.0) vs 4.5 (range 2.3–17.6) × 106 CD34+ cells per kilo were reinfused in the CD34+ group and PBPC group, respectively. No difference was observed between the two groups with regard to time to haematological engraftment, reconstitution of B cells, CD56+ cells and T cells at 3 and 12 months and infectious episodes after HDT. Two (5%) treatment-related deaths, one in each group, were observed. The overall survival at 4 years was 86% for the CD34+group and 74% for the PBPC group with a median follow-up of 37 months (range 1–61) and 46 months (range 4–82), respectively (P = 0.9). The results of this study demonstrate that the use of CD34+ cells is safe and has no adverse effects either with respect to haematological, immune reconstitution or to infections after HDT. Bone Marrow Transplantation (2001) 28, 849–857.
Databáze: OpenAIRE
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