CD34-selected stem cell boost was an effective treatment for refractory poor hematopoietic reconstitution after haploidentical hematopoietic stem cell transplantation.

IF 3.7 3区医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Cytotherapy Pub Date : 2025-03-17 DOI:10.1016/j.jcyt.2025.03.004

Yun He, Rui Ma, Yuanyuan Zhang, Huan Chen, Yao Chen, Yuhong Chen, Tingting Han, Wei Han, Fengrong Wang, Haixia Fu, Chenhua Yan, Meng Lv, Xiaodong Mo, Yifei Cheng, Yu Wang, Lanping Xu, Xiaohui Zhang, Xiaojun Huang, Yuqian Sun

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引用次数: 0

Abstract

Background: Poor hematopoietic reconstitution (PHR), especially poor graft function (PGF) and prolonged isolated thrombocytopenia (PT), is a life-threatening complication after allo- hematopoietic stem cell transplantation (HSCT). Currently, almost no studies have analyzed CD34+-selected stem cells "boost" (SCB) after haplo-HSCT. Hence, in this study, we focused specifically on refractory PHR after haplo-HSCT.

Objective: To retrospectively evaluate the safety and efficacy of donor- CD34+ SCB for the treatment of refractory PHR after haplo-HSCT.

Study design: Twenty-seven patients with refractory PHR who received a donor-CD34+ selected SCB at Peking University People's Hospital were retrospectively analyzed. The patients' hematopoietic response, incidence of graft-versus-host disease, and survival after CD34+ cell boost were evaluated.

Results: Among the 27 patients with refractory PHR who received a CD34+ SCB, five patients (18.5%) were diagnosed with primary PGF, 17 patients (63%) were diagnosed with secondary PGF, and five patients (18.5%) were diagnosed with PT. The median time to PHR diagnosis was 63 days (range: 42-330 days), and the median time to the donor CD34+ boost was 456 days (range: 58-853 days). The median number of infused CD34+ cells was 2.589 × 10⁶/kg (range: 0.738-16.8 × 10⁶/kg). Among the 27 patients, 15 achieved hematologic response (55.56%). Among the responders, the median time of absolute neutrophil count (ANC) response was 15 days (range: 10-158 days), and the median time of erythroid reconstitution was 18 days (range: 7-158 days). The platelet reconstitution time was 22 days (range: 7-171 days). Patients with acute infection during CD34+ SCB were noted to have a worse hematologic response (1/15 vs. 5/12, P = 0.03). The mortality rate significantly differed between patients who achieved complete hematologic response and those who did not (100% vs. 33.3%, respectively; P < 00.001). Infections were the leading cause of death (n = 5/8, 62.5%).

Conclusion: CD34+-selected SCB is a potentially effective treatment for refractory PHR after haploidentical HSCT.

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来源期刊

Cytotherapy 医学-生物工程与应用微生物

CiteScore

6.30

自引率

4.40%

发文量

683

审稿时长

49 days

期刊介绍： The journal brings readers the latest developments in the fast moving field of cellular therapy in man. This includes cell therapy for cancer, immune disorders, inherited diseases, tissue repair and regenerative medicine. The journal covers the science, translational development and treatment with variety of cell types including hematopoietic stem cells, immune cells (dendritic cells, NK, cells, T cells, antigen presenting cells) mesenchymal stromal cells, adipose cells, nerve, muscle, vascular and endothelial cells, and induced pluripotential stem cells. We also welcome manuscripts on subcellular derivatives such as exosomes. A specific focus is on translational research that brings cell therapy to the clinic. Cytotherapy publishes original papers, reviews, position papers editorials, commentaries and letters to the editor. We welcome "Protocols in Cytotherapy" bringing standard operating procedure for production specific cell types for clinical use within the reach of the readership.