CD34+-Selected Autologous Peripheral Blood Stem Cell Transplantation Conditioned With Total Body Irradiation for Malignant Lymphoma: Increased Risk of Infectious Complications

  • Satoko Maeda
  • Yoshitoyo Kagami
  • Michinori Ogura
  • Hirofumi Taji
  • Ritsuro Suzuki
  • Eisei Kondo
  • Shouji Asakura
  • Takahiro Takeuchi
  • Kazuhisa Miura
  • Manabu Ando
  • Shigeo Nakamura
  • Tatsuya Ito
  • Tomohiro Kinoshita
  • Ryuzo Ueda
  • Yasuo Morishima
Case Report

Abstract

Although high-dose chemotherapy with autologous peripheral blood stem cell transplantation (autoPBSCT) has been shown or confirmed to be an effective treatment for high-risk and relapsed non-Hodgkin’s lymphoma (NHL), relapse after autoPBSCT remains a serious problem. In a clinical trial to overcome relapse, we adopted a treatment plan in which PBSCs purified in vitro to CD34+ cells to deplete tumor cells (CD34+ autoPBSCT), total body irradiation (TBI) of 1200 cGy, and melphalan, 180 mg/m2, were used as a preconditioning regimen. Eighteen patients with relapsed or high-risk NHL participated in the study. This study compared the incidence of complications following CD34+ autoPBSCT preconditioned with the TBI regimen (n = 10): the TBI group; CD34+ autoPBSCT with the non-TBI regimen (n = 8): the non-TBI group; and unselected autoPBSCT with the non-TBI regimen (n = 19): the unselected autoPBSCT control group.After day 30 posttransplantation, 6 of 10 patients treated with the TBI regimen developed 11 infectious complications in total, compared with only 1 of 8 patients treated with the non-TBI regimen and 4 of 19 patients given unselected autoPBSCT.Two fatal complications occurred in the TBI group, but none occurred in the other 2 groups. The CD4+ lymphocyte count at 1 month posttransplantation was significantly lower in the TBI group than in the unse-lected autoPBSCT group.These findings suggest that the addition of TBI to the preconditioning regimen for CD34+ autoPBSCT is associated with an increased incidence of severe infectious complications after transplantation.

Key words

CD34+ cell Autologous peripheral blood stem cell transplantation Lymphoma Total body irradiation Opportunistic infection 

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Copyright information

© The Japanese Society of Hematology 2001

Authors and Affiliations

  • Satoko Maeda
    • 1
  • Yoshitoyo Kagami
    • 1
  • Michinori Ogura
    • 1
  • Hirofumi Taji
    • 1
  • Ritsuro Suzuki
    • 1
  • Eisei Kondo
    • 1
  • Shouji Asakura
    • 1
  • Takahiro Takeuchi
    • 1
    • 4
  • Kazuhisa Miura
    • 1
    • 4
  • Manabu Ando
    • 2
  • Shigeo Nakamura
    • 3
  • Tatsuya Ito
    • 5
  • Tomohiro Kinoshita
    • 5
  • Ryuzo Ueda
    • 4
  • Yasuo Morishima
    • 1
  1. 1.Department of Hematology and ChemotherapyAichi Cancer Center HospitalAichiJapan
  2. 2.Department of Clinical LaboratoryAichi Cancer Center HospitalAichiJapan
  3. 3.Department of Pathology and GeneticsAichi Cancer Center HospitalAichiJapan
  4. 4.Second Department of Internal MedicineNagoya City University School of MedicineNagoyaJapan
  5. 5.First Department of Internal MedicineNagoya University School of MedicineNagoyaJapan
  6. 6.Department of Hematology and ChemotherapyAichi Cancer Center HospitalChikusa-ku NagoyaJapan
  7. 7.Department of HematologyMeitetsu HospitalNagoyaJapan

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