Article ID Journal Published Year Pages File Type
9904268 Biology of Blood and Marrow Transplantation 2005 7 Pages PDF
Abstract
Allogeneic stem cell transplantation (ASCT) has improved the outcome of acute myelogenous leukemia (AML). To further improve the treatment outcome of ASCT in AML, finding a modifiable prognostic factor is mandatory. We evaluated the effect of CD34+ cell dose on survival in allogeneic bone marrow transplantation (BMT) from HLA-matched sibling donors for AML patients in first complete remission (CR1). The 99 patients included in our analysis were classified into high CD34+ cell dose group (CD34+ cells ≥ 2.5 × 106/kg) and low CD34+ cell dose group (CD34+ cells < 2.5 × 106/kg). The high CD34+ cell dose patients had better overall survival (5-year overall survival rate, 75% ± 6% vs 52% ± 9%; P = .01) and leukemia-free survival (5-year leukemia-free survival rate, 70% ± 6% vs 44% ± 9%; P = .04). CD34+ cell dose was the only independent prognostic factor in overall survival and leukemia-free survival. The high CD34+ cell dose group had a lower relapse incidence with a borderline statistical significance (5-year relapse rate, 27% ± 6% vs 50% ± 10%; P = .09). There were no differences in the engraftment of neutrophil and platelet, grade II-IV acute graft-versus-host disease (GVHD), extensive-stage chronic GVHD, and transplant-related mortality between the high and low CD34+ cell dose groups. We confirmed that high CD34+ cell dose favorably affects the outcomes in allogeneic BMT for AML. The effort to attain a high CD34+ cell dose should be pursued during bone marrow harvest in allogeneic BMT for AML in CR1.
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