Low CD34 dose is associated with poor survival after reduced-intensity conditioning allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndrome

Johan Törlén, Olle Ringdén, Jennifer Le-Rademacher, Minoo Batiwalla, Junfang Chen, Tom Erkers, Vincent Ho, Partow Kebriaei, Carolyn Keever-Taylor, Tamila Kindwall-Keller, Hillard M. Lazarus, Mary J. Laughlin, Michael Lill, Tracey O'Brien, Miguel Angel Perales, Vanderson Rocha, Bipin N. Savani, David Szwajcer, David Valcarcel, Mary Eapen

Research output: Contribution to journalArticle

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Abstract

Reduced-intensity conditioning/nonmyeloablative conditioning regimens are increasingly used in allogeneic hematopoietic cell transplantation (HCT). Reports have shown CD34+ dose to be important for transplantation outcome using myeloablative conditioning. The role of CD34+ dose of peripheral blood progenitor cells (PBPC) has not been previously analyzed in a large population undergoing reduced-intensity conditioning/nonmyeloablative HCT. We studied 1054 patients, ages 45 to 75years, with acute myeloid leukemia or myelodysplastic syndrome who underwent transplantation between 2002 and 2011. Results of multivariate analysis showed that PBPC from HLA-matched siblings containing <4×106 CD34+/kg was associated with higher nonrelapse mortality (hazard ratio [HR], 2.03; P=001), overall mortality (HR, 1.48; P=008), and lower neutrophil (odds ratio [OR], .76; P=03) and platelet (OR, .76; P=03) recovery. PBPC from unrelated donors with CD34+ dose < 6×106 CD34+/kg was also associated with higher nonrelapse (HR, 1.38; P=02) and overall mortality (HR, 1.20; P=05). In contrast to reports after myeloablative HCT, CD34+ dose did not affect relapse or graft-versus-host disease with either donor type. An upper cell dose limit was not associated with adverse outcomes. These data suggest that PBPC CD34+ doses >4×106 CD34+/kg and >6×106 CD34+/kg are optimal for HLA-matched sibling and unrelated donor HCT, respectively.

Original languageEnglish (US)
Pages (from-to)1418-1425
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number9
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Myelodysplastic Syndromes
Homologous Transplantation
Acute Myeloid Leukemia
Cell Transplantation
Survival
Siblings
Blood Cells
Stem Cells
Transplantation
Unrelated Donors
Multivariate Analysis
Conditioning (Psychology)
Population

Keywords

  • Cellular content
  • Hematological malignancy
  • Peripheral blood graft

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Low CD34 dose is associated with poor survival after reduced-intensity conditioning allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndrome. / Törlén, Johan; Ringdén, Olle; Le-Rademacher, Jennifer; Batiwalla, Minoo; Chen, Junfang; Erkers, Tom; Ho, Vincent; Kebriaei, Partow; Keever-Taylor, Carolyn; Kindwall-Keller, Tamila; Lazarus, Hillard M.; Laughlin, Mary J.; Lill, Michael; O'Brien, Tracey; Perales, Miguel Angel; Rocha, Vanderson; Savani, Bipin N.; Szwajcer, David; Valcarcel, David; Eapen, Mary.

In: Biology of Blood and Marrow Transplantation, Vol. 20, No. 9, 01.01.2014, p. 1418-1425.

Research output: Contribution to journalArticle

Törlén, J, Ringdén, O, Le-Rademacher, J, Batiwalla, M, Chen, J, Erkers, T, Ho, V, Kebriaei, P, Keever-Taylor, C, Kindwall-Keller, T, Lazarus, HM, Laughlin, MJ, Lill, M, O'Brien, T, Perales, MA, Rocha, V, Savani, BN, Szwajcer, D, Valcarcel, D & Eapen, M 2014, 'Low CD34 dose is associated with poor survival after reduced-intensity conditioning allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndrome', Biology of Blood and Marrow Transplantation, vol. 20, no. 9, pp. 1418-1425. https://doi.org/10.1016/j.bbmt.2014.05.021
Törlén, Johan ; Ringdén, Olle ; Le-Rademacher, Jennifer ; Batiwalla, Minoo ; Chen, Junfang ; Erkers, Tom ; Ho, Vincent ; Kebriaei, Partow ; Keever-Taylor, Carolyn ; Kindwall-Keller, Tamila ; Lazarus, Hillard M. ; Laughlin, Mary J. ; Lill, Michael ; O'Brien, Tracey ; Perales, Miguel Angel ; Rocha, Vanderson ; Savani, Bipin N. ; Szwajcer, David ; Valcarcel, David ; Eapen, Mary. / Low CD34 dose is associated with poor survival after reduced-intensity conditioning allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndrome. In: Biology of Blood and Marrow Transplantation. 2014 ; Vol. 20, No. 9. pp. 1418-1425.
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AU - Ringdén, Olle

AU - Le-Rademacher, Jennifer

AU - Batiwalla, Minoo

AU - Chen, Junfang

AU - Erkers, Tom

AU - Ho, Vincent

AU - Kebriaei, Partow

AU - Keever-Taylor, Carolyn

AU - Kindwall-Keller, Tamila

AU - Lazarus, Hillard M.

AU - Laughlin, Mary J.

AU - Lill, Michael

AU - O'Brien, Tracey

AU - Perales, Miguel Angel

AU - Rocha, Vanderson

AU - Savani, Bipin N.

AU - Szwajcer, David

AU - Valcarcel, David

AU - Eapen, Mary

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