Rapid engraftment after allogeneic transplantation using CD34-enriched marrow cells

K. Cornetta, V. Gharpure, B. Mills, R. Hromas, R. Abonour, E. R. Broun, C. M. Traycoff, M. Hanna, N. Wyman, C. Danielson, R. Gonin, L. K. Kunkel, F. Oldham, E. F. Srour

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Bone marrow cells expressing the surface antigen CD34 comprise approximately 1% of harvested marrow and are highly enriched for marrow progenitor cells, including the cells believed to be responsible for long-term engraftment following hone marrow transplantation (BMT). Selection of CD34-expressing cells was applied in allogeneic BMT (alloBMT) to decrease the number of T lymphocytes in the infused marrow in an attempt to prevent severe graft-versus-host disease (GVHD). We report 14 patients who underwent HLA-identical sibling-matched alloBMT with marrow-enriched for CD34 cells using the Isolex 300 SA device. Patients received total body irradiation, thiotepa, cyclophosphamide, antithymocyte globulin and methylprednisolone prior to marrow infusion. No post-transplantation immunosuppressive therapy was given except for a 5-week course of steroids. The purity of the infused marrow was 64.9 ± 6.0% (mean ± s.e.m.) CD34-positive cells and patients received a mean of 1.24 ± 0.21 x 106 CD34 cells/kg. A mean of 9.4 ± 1.7 x 104 CD3 T cells/kg were present in the CD34-enriched product, representing a 2.7 ± 0.1 log depletion. There were no graft rejections and patients achieved a sustained absolute granulocyte count of > 500 in a median of 10.5 days and a sustained platelet engraftment of > 20,000 untransfused in a median of 27 days. Patients were discharged a median of 21.5 days after marrow infusion. There were no instances of grade III or IV graft-versus-host disease (GVHD) and no unexpected adverse events during the transplant hospitalization. With a median follow-up of 12 months, the estimated 100 day survival is 86 ± 9%. CD34 selection in alloBMT permits rapid engraftment without unanticipated toxicities.

Original languageEnglish (US)
Pages (from-to)65-71
Number of pages7
JournalBone marrow transplantation
Volume21
Issue number1
DOIs
StatePublished - Jan 1 1998

Keywords

  • Allogeneic transplantation
  • CD34 selection
  • Engraftment

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Cornetta, K., Gharpure, V., Mills, B., Hromas, R., Abonour, R., Broun, E. R., Traycoff, C. M., Hanna, M., Wyman, N., Danielson, C., Gonin, R., Kunkel, L. K., Oldham, F., & Srour, E. F. (1998). Rapid engraftment after allogeneic transplantation using CD34-enriched marrow cells. Bone marrow transplantation, 21(1), 65-71. https://doi.org/10.1038/sj.bmt.1701048