CD34+-selected autologous peripheral blood stem cell transplantation conditioned with total body irradiation for malignant lymphoma: increased risk of infectious complications.

Abstract

Although high-dose chemotherapy with autologous peripheral blood stem cell transplantation (autoPBSCT) has been shown or confirmed to be an effective treatment for high-risk and relapsed non-Hodgkin's lymphoma (NHL), relapse after autoPBSCT remains a serious problem. In a clinical trial to overcome relapse, we adopted a treatment plan in which PBSCs purified in vitro to CD34+ cells to deplete tumor cells (CD34+ autoPBSCT), total body irradiation (TBI) of 1200 cGy, and melphalan, 180 mg/m2, were used as a preconditioning regimen. Eighteen patients with relapsed or high-risk NHL participated in the study. This study compared the incidence of complications following CD34+ autoPBSCT preconditioned with the TBI regimen (n = 10): the TBI group; CD34+ autoPBSCT with the non-TBI regimen (n = 8): the non-TBI group; and unselected autoPBSCT with the non-TBI regimen (n = 19): the unselected autoPBSCT control group. After day 30 posttransplantation, 6 of 10 patients treated with the TBI regimen developed 11 infectious complications in total, compared with only 1 of 8 patients treated with the non-TBI regimen and 4 of 19 patients given unselected autoPBSCT. Two fatal complications occurred in the TBI group, but none occurred in the other 2 groups. The CD4+ lymphocyte count at 1 month posttransplantation was significantly lower in the TBI group than in the unselected autoPBSCT group. These findings suggest that the addition of TBI to the preconditioning regimen for CD34+ autoPBSCT is associated with an increased incidence of severe infectious complications after transplantation.

• Authors: S Maeda, Y Kagami, M Ogura, H Taji, R Suzuki, E Kondo, S Asakura, T Takeuchi, K Miura, M Ando, S Nakamura, T Ito, T Kinoshita, R Ueda, Y Morishima
• Journal: International journal of hematology (Int J Hematol) Vol. 74 Issue 2 Pg. 214-21 (Aug 2001) ISSN: 0925-5710 [Print] Japan
• PMID: 11594525 (Publication Type: Clinical Trial, Clinical Trial, Phase I, Clinical Trial, Phase II, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, CD34

Topics

• Adult
• Antigens, CD34
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Combined Modality Therapy (methods)
• Female
• Hematopoietic Stem Cell Transplantation (adverse effects, methods, standards)
• Humans
• Infections (etiology)
• Lymphoma (complications, therapy)
• Male
• Middle Aged
• Risk Factors
• Transplantation Conditioning (adverse effects, methods, standards)
• Transplantation, Autologous (adverse effects, methods, standards)
• Treatment Outcome
• Whole-Body Irradiation (adverse effects, standards)