The effect of bone marrow graft composition on pediatric bone marrow transplantation outcomes

Pediatr Transplant. 2018 Dec;22(8):e13287. doi: 10.1111/petr.13287. Epub 2018 Aug 29.

Abstract

Hematopoietic stem cell graft cellular composition has been generally accepted to impact outcomes. Recent studies question this hypothesis. We conducted a single-center retrospective study of sixty-one pediatric BMT recipients for malignant (68%) and nonmalignant diseases (32%) examining effects of graft composition on engraftment, acute GVHD, chronic GVHD, and survival at day 100 and 1 year. Grafts contained a median of 3.63 x 08 TNC/kg (range: 0.031-10.31 x 108 TNC/kg) and 4.09 x 106 CD34+ /kg (range: 0.76-24.15 x 106 CD34+ /kg) with median neutrophil and platelet engraftment times of 17 and 29 days, respectively. A univariate analysis showed a trend for increasing TNC and increasing time to neutrophil engraftment HR: 0.875; CI: 0.075-1.001). Increasing CD34+ counts shortened time to platelet engraftment (HR: 1.085; CI: 1.015-1.161). No significant relationship was found between TNC, CD34+ , or CD3+ and acute or chronic GVHD. TNC or CD34+ did not affect day 100, 1-year survival, or 2-year survival. Increasing CD3+ counts demonstrated a negative trend on day 100 survival (HR: 1.108; CI: 1.001-1.036) but not 1-year survival or 2-year survival. These results add additional data questioning the effect of graft composition on outcomes in pediatric BMT patients with important ramifications for the management of donors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antigens, CD34 / metabolism
  • Blood Platelets / cytology
  • Bone Marrow / pathology*
  • Bone Marrow Transplantation*
  • Child
  • Child, Preschool
  • Female
  • Graft Survival*
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation*
  • Hematopoietic Stem Cells / cytology
  • Humans
  • Infant
  • Male
  • Neoplasms / therapy*
  • Neutrophils / cytology
  • Reproducibility of Results
  • Retrospective Studies
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Antigens, CD34