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Long-term results after transplantation of CD34+ selected (CellPro) versus unselected peripheral blood progenitor cells (PBPC) from related allogeneic donors

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Abstract

Purpose

To determine the long-term outcome of patients after allogeneic transplantation of T-cell depleted versus unmanipulated hematopoietic stem cell grafts with respect to incidence of GvHD and overall survival in 50 consecutive patients.

Methods

In this prospective phase II study utilizing biological randomization, 50 sibling donors were mobilized with G-CSF. Positive selection of CD34+ cells (Ceprate SC; CellPro, USA) was performed in good mobilizers (n = 25; group A), but not in poor mobilizers (n = 25; group B). Patients had hematological malignancies. Median patient age was 44 years (range, 19–57). Numbers of CD3+ cells were 0.5 ± 0.4 × 106/kg in group A and 216 ± 127 × 106/kg in group B.

Results

Hematological recovery was rapid in both groups. Patients in group A had no grade III–IV acute GvHD, whereas 6 out of 22 evaluable patients in group B had grade III–IV acute GvHD with fatal outcome in four cases (P < 0.01). Similarly, the incidence of chronic GvHD was lower in patients in group A (35 vs. 65%). However, there was a higher relapse rate in group A (11/25) versus group B (4/25, P < 0.05). At a follow-up of 10 years after transplantation, eight (32%) and 10 patients (40%) were relapse-free and alive in groups A and B, respectively.

Conclusions

Risk factors for survival in a multivariate analysis were remission status prior to transplantation (CR vs. no CR), occurrence of acute and chronic GvHD, and relapse. The use of the CellPro device for CD34 positive selection per se did not have an influence on overall survival.

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Acknowledgments

Hans-Georg Kopp is supported by the Max Eder Stiftung, Deutsche Krebshilfe, Bonn, Germany and by grants from the German Research Foundation (SFB685, project A7; SFB 773, project C6). The authors gratefully acknowledge the excellent technical assistance of Mrs. Florida Strehle, Mr. Martin Struppe, and Mrs. Anja Wolf.

Conflict of interest statement

There is no conflict of interest to declare.

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Author notes

  1. Stefan Scheding

    Present address: Department of Hematology and Lund Stem Cell Center, Lund University Hospital, University of Lund, Lund, Sweden

  2. Wolfram Brugger

    Present address: Department of Hematology and Oncology, Internal Medicine II, Schwarzwald-Baar Clinic, Villingen-Schwenningen, Germany

Authors and Affiliations

  1. Department of Internal Medicine II, Division of Hematology and Oncology, Immunology, and Rheumatology, University of Tübingen, Tübingen, Germany

    Hans-Georg Kopp, Stefan Wirths, Christoph Faul, Wolfgang Bethge, Stefan Scheding, Wolfram Brugger, Lothar Kanz & Wichard Vogel

  2. Department of Internal Medicine II, Division of Hematology and Oncology, University of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany

    Wichard Vogel

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  1. Hans-Georg Kopp
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Correspondence to Wichard Vogel.

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Kopp, HG., Wirths, S., Faul, C. et al. Long-term results after transplantation of CD34+ selected (CellPro) versus unselected peripheral blood progenitor cells (PBPC) from related allogeneic donors. J Cancer Res Clin Oncol 136, 1921–1927 (2010). https://doi.org/10.1007/s00432-010-0851-6

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  • DOI: https://doi.org/10.1007/s00432-010-0851-6

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