| Title | Effects of CD34(+) cell dose on haematopoietic recovery in acute lymphoblastic leukaemia patients with positive pretransplant measurable residual disease |
| Authors | Wang, Yuewen Mo, Xiaodong Cheng, Yifei Chen, Yuhong Lv, Meng Wang, Fengrong Yan, Chenhua Han, Wei Chen, Huan Xu, Lanping Wang, Yu Zhang, Xiaohui Liu, Kaiyan Huang, Xiaojun Chang, Yingjun |
| Affiliation | Peking Univ Peoples Hosp, Beijing, Peoples R China Peking Univ, Inst Hematol, Natl Clin Res Ctr Hematol Dis, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing, Peoples R China Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China Chinese Acad Med Sci, Res Unit Key Tech Diag & Treatments Hematol Malig, Beijing, Peoples R China |
| Keywords | UNMANIPULATED HAPLOIDENTICAL BLOOD ACUTE MYELOID-LEUKEMIA UMBILICAL-CORD BLOOD BONE-MARROW POSTTRANSPLANTATION CYCLOPHOSPHAMIDE PLATELET ENGRAFTMENT PEDIATRIC-PATIENTS CLINICAL-OUTCOMES GRAFT COMPOSITION TRANSPLANTATION |
| Issue Date | Oct-2022 |
| Publisher | INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY |
| Abstract | Introduction A higher CD34(+) cell dose in allografts is associated with faster haematopoietic recovery after allogeneic haematopoietic stem cell transplantation (allo-HSCT). Leukaemia stem cells impair normal bone marrow (BM) niches and induce BM failure during leukemogenesis. However, whether measurable residual disease (MRD), known as the persistence of low-level leukaemic cells, could influence the effects of CD34(+) cell dose on haematopoietic recovery after transplantation in acute lymphoblastic leukaemia (ALL) patients is unknown. Methods A total of 975 ALL patients were enrolled and classified into pre-HSCT MRD-positive and MRD-negative subgroups. Cox proportional hazard regression models were built for time-to-event outcomes. Multivariate analysis was performed to determine independent influencing factors from the univariate analysis. Results An appropriate CD34(+) cell dose was positively associated with faster haematopoietic recovery in the total ALL population. More importantly, in pre-HSCT MRD-positive ALL patients, a higher CD34(+) cell dose (>= 2.76 x 10(6)/kg) was related to faster neutrophil (HR 1.330, 95% CI 1.045-1.692, p = 0.021) and platelet engraftment (HR 1.808, 95% CI 1.412-2.316, p < 0.001) in multivariate analysis. CD34(+) cell dose was a crucial factor associated with either engraftment or transplant outcomes, although we did not demonstrate direct correlations of CD34(+) cell dose with relapse, TRM, LFS or OS after allo-HSCT. Conclusion Our results indicated that no additional CD34(+) stem and progenitor cell harvests were needed to ensure successful haematopoietic recovery in pre-HSCT MRD-positive patients compared to pre-HSCT MRD-negative patients. |
| URI | http://hdl.handle.net/20.500.11897/655680 |
| ISSN | 1751-5521 |
| DOI | 10.1111/ijlh.13974 |
| Indexed | SCI(E) |
| Appears in Collections: | 人民医院 |
