Journal Article

Influence of graft composition in patients with hematological malignancies undergoing ATG-based haploidentical stem cell transplantation

Shi, Wei, Zhang, Ran, Lu, Xuan, Tang, Liang V., Zhong, Zhaodong, You, Yong, Xia, Linghui, Wang, Huafang, Yan, Han

2022

Overview

To determine the influence of graft composition in haplo-HSCT, we summarized the long-term consequences of 251 consecutive transplantations from haploidentical donors. For donor-recipient HLA3/6-matched setting, 125 cases used G-CSF-mobilized BM and PBSCs mixtures, while 126 cases only used G-CSF-mobilized PBSCs in HLA4/6-matched transplantation. On the one hand, we wanted to explore the effect of harvests (CD34+ cells and TNCs dosages) on transplantation outcome in the context of haplo-HSCT no matter HLA4/6 or HLA3/6-matched setting. On the other hand, for patients using G-CSF-mobilized BM and PBSCs combination in HLA3/6-matched setting, we attempted to analyze whether TNCs or CD34+ cells from G-CSF-mobilized BM or G-CSF-mobilized PBSCs play the most paramount role on transplantation prognosis. Collectively, patients with hematologic malignancies receiving G-CSF-primed BM and PBSCs harvests had comparable consequences with patients only receiving G-CSF-mobilized PBSCs. Moreover, when divided all patients averagely according to the total amount of transfused nucleated cells, 3-year TRM of the intermediate group (13.06-18.05×10 8 /kg) was only 4.9%, which was remarkably reduced when compared to lower and higher groups with corresponding values 18.3%, 19.6% ( P =0.026). The 3-year probabilities of OS and DFS of this intermediate group were 72.6% and 66.5%, which were slightly improved than the lower and higher groups. Most importantly, these data suggest that the transfused nucleated cells from G-CSF-primed BM above than 5.20×10 8 /kg could achieve remarkably lower TRM in haplo-HSCT receiving G-CSF-mobilized BM and PBSCs harvests. These encouraging results suggested that we could improve the efficacy of haplo-HSCT by adjusting the component and relative ratio of transfused graft cells. Nevertheless, the above findings should be confirmed in a randomized prospective comparative research with adequate follow-up.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Antigens / Bone marrow / CD34 antigen / Cytomegalovirus / Disease prevention / G-CSF-mobilized BM cells / G-CSF-mobilized PBSCs / graft composition / Graft versus host disease / Granulocyte colony-stimulating factor / Granulocytes / haploidentical hematopoietic stem cell transplantation / Haplotypes / Hematology / Histocompatibility antigen HLA / Immunology / Leukemia / Leukocytes / Malignancy / Medical prognosis / Mortality / Myelodysplastic syndromes / Neutrophils / Patients / Stem cell transplantation / total nucleated cells