Extensive chronic GVHD is associated with donor blood CD34+ cell count after G-CSF mobilization in non-myeloablative allogeneic PBSC transplantation

Bone Marrow Transplant. 2012 Dec;47(12):1564-8. doi: 10.1038/bmt.2012.75. Epub 2012 May 21.

Abstract

The correlation between the incidence of GVHD and the number of infused CD34(+) cells remains controversial for PBSC transplantation after a reduced-intensity-conditioning (RIC) regimen. We evaluated 99 patients transplanted with an HLA-identical sibling after the same RIC (2-Gy-TBI/fludarabine). Donor and recipient characteristics, donor's blood G-CSF-mobilized CD34(+) cell count, and number of infused CD34(+) and CD3(+) cells were analyzed as risk factors for acute and chronic GVHD There was a trend for an increased incidence of extensive chronic GVHD in the quartile of patients receiving more than 10 × 10(6) CD34(+) cells/kg (P = 0.05). Interestingly, the number of donor's blood CD34(+) cells at day 5 of G-CSF mobilization was closely associated with the incidence of extensive chronic GVHD, that is, 48% (95% CI: 28-68) at 24-months in the quartile of patients whose donors had the highest CD34(+) cell counts versus 24.3% (95% CI: 14-34) in the other patients (P = 0.007). In multivariate analysis, the only factor correlating with extensive chronic GVHD (cGVHD) was the donor's blood CD34(+) cell count after G-CSF (HR 2.49; 95% CI: 1.16-5.35, P = 0.019). This study shows that the incidence of cGVHD is more strongly associated with the donor's ability to mobilize CD34(+) cells than with the number of infused CD34(+) cells.

MeSH terms

  • Adult
  • Aged
  • Antigens, CD34 / blood
  • Antigens, CD34 / immunology*
  • Chronic Disease
  • Graft vs Host Disease / blood
  • Graft vs Host Disease / immunology*
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cells / metabolism
  • Humans
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / methods*
  • Retrospective Studies
  • Transplantation, Homologous
  • Young Adult

Substances

  • Antigens, CD34
  • Granulocyte Colony-Stimulating Factor