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

By Nathalie Dhédin, Thomas Prébet, Régis Peffault De Latour, Sandrine Katsahian, Mathieu Kuentz, Nicole Piard, D. Réa, Françoise Norol, Jean-Pierre Jouet, Jean-Antoine Ribeil, Reza Tabrizi, B. Rio, Bruno Lioure, Pierre Tiberghien, Jean Bourhis, A. Sirvent, Pierre Bordigoni, Didier Blaise, Mauricette Michallet and Jean-Paul Vernant

Abstract

International audienceThe 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

Topics: [ SDV.IMM ] Life Sciences [q-bio]/Immunology
Publisher: Nature Publishing Group
Year: 2012
DOI identifier: 10.1038/bmt.2012.75
OAI identifier: oai:HAL:inserm-00821516v1
Provided by: Hal-Diderot
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