Allogeneic transplantation of CD34+-selected cells from peripheral blood in patients with myeloid malignancies in early phase: a case control comparison with unmodified peripheral blood transplantation.

Abstract

An allogeneic transplantation of CD34(+)-selected cells from peripheral blood (allo-PBT/CD34(+)) from HLA-identical sibling donors was performed in 50 adult patients with acute myeloid leukemia in first complete remission (AML CR1) (n = 29), myelodysplastic syndrome (MDS) (n = 4), or chronic myeloid leukemia in first chronic phase (CML CP1) (n = 17). Clinical results were compared to a concurrent group of 50 patients transplanted with unmodified peripheral blood progenitor cells (allo-PBT), matched for age, diagnosis, and disease stage. The median follow-up period was 29 months (range 1-69). The actuarial probability of developing acute GVHD clinical grade II to IV was 16% (95%CI: 6-26) for the allo-PBT/CD34(+) group and 41% (95%CI: 29-57) for the allo-PBT group (P = 0.002). The actuarial probability of developing extensive chronic GVHD was 22% (95%CI: 8-36) for the allo-PBT/CD34(+) group and 47% (95%CI: 31-63) for the allo-PBT group (P = 0.02). Recipients of allo-PBT/CD34(+) had less toxicity associated with the transplant and better Karnofsky index at the last follow-up. For AML/MDS patients, the actuarial probability of disease-free survival (DFS) for recipients of allo-PBT/CD34(+) and allo-PBT was 65% (95%CI: 45-85) vs43% (95%CI: 28-58) (P = 0.05), respectively. These data provide a rationale for a randomised trial of allo-PBT/CD34(+) vs allo-PBT in AML/MDS patients in early stage of the disease.

• Authors: A Urbano-Ispizua, S Brunet, C Solano, J M Moraleda, M Rovira, J Zuazu, J de La Rubia, J Bargay, D Caballero, J L Díez-Martín, E Ojeda, J P Pérez de Oteiza, C Ferrá, I Espigado, A Alegre, J de La Serna, P Torres, C Riu, J Odriozola, C Rozman, J Sierra, J García-Conde, E Montserrat, Spanish Group of Allo-PBT
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 28 Issue 4 Pg. 349-54 (Aug 2001) ISSN: 0268-3369 [Print] England
• PMID: 11571506 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, CD34

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Anemia, Refractory, with Excess of Blasts (mortality, therapy)
• Antigens, CD34 (biosynthesis, blood)
• Blood Transfusion (mortality)
• Case-Control Studies
• Chronic Disease
• Disease-Free Survival
• Female
• Graft vs Host Disease (epidemiology, mortality)
• Hematopoietic Stem Cell Transplantation (adverse effects, mortality)
• Humans
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (mortality, therapy)
• Leukemia, Myeloid, Acute (mortality, therapy)
• Male
• Middle Aged
• Recurrence
• Transplantation, Homologous