Haerim Chung, Hye Won Kook, Hyunsoo Cho, Ji Eun Jang, June-Won Cheong
{"title":"CD34+细胞剂量对急性白血病单倍体外周血干细胞移植结果的影响。","authors":"Haerim Chung, Hye Won Kook, Hyunsoo Cho, Ji Eun Jang, June-Won Cheong","doi":"10.1007/s44313-025-00091-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Allogeneic hematopoietic stem cell transplantation remains a curative option for acute leukemia. While an adequate CD34<sup>+</sup> cell dose is essential for engraftment, the optimal upper threshold in haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 81 patients with acute leukemia who underwent haplo-PBSCT with reduced-intensity conditioning between 2010 and 2020. Patients were stratified by CD34<sup>+</sup> cell dose (< 8 × 10<sup>6</sup>/kg vs. ≥ 8 × 10<sup>6</sup>/kg). Clinical outcomes, including overall survival (OS), non-relapse mortality (NRM), graft failure, and graft-versus-host disease (GVHD) incidence, were compared.</p><p><strong>Results: </strong>A higher CD34<sup>+</sup> cell dose was associated with inferior OS (P = 0.022) and increased NRM (P = 0.002), despite similar rates of graft failure and acute GVHD. Chronic GVHD was more frequent in the higher dose group, though the difference was not statistically significant. Multivariate Cox analysis confirmed a high CD34<sup>+</sup> cell dose as an independent predictor of poor OS (HR 2.054, P = 0.031).</p><p><strong>Conclusion: </strong>These findings suggest that excessively high doses may adversely affect survival by increasing transplant-related toxicity. Graft cell dose should be carefully balanced to optimize outcomes in haplo-PBSCT.</p>","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":"60 1","pages":"42"},"PeriodicalIF":2.8000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331545/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of CD34<sup>+</sup> cell dose on outcomes of haploidentical peripheral blood stem cell transplantation in acute leukemia.\",\"authors\":\"Haerim Chung, Hye Won Kook, Hyunsoo Cho, Ji Eun Jang, June-Won Cheong\",\"doi\":\"10.1007/s44313-025-00091-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Allogeneic hematopoietic stem cell transplantation remains a curative option for acute leukemia. While an adequate CD34<sup>+</sup> cell dose is essential for engraftment, the optimal upper threshold in haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 81 patients with acute leukemia who underwent haplo-PBSCT with reduced-intensity conditioning between 2010 and 2020. Patients were stratified by CD34<sup>+</sup> cell dose (< 8 × 10<sup>6</sup>/kg vs. ≥ 8 × 10<sup>6</sup>/kg). Clinical outcomes, including overall survival (OS), non-relapse mortality (NRM), graft failure, and graft-versus-host disease (GVHD) incidence, were compared.</p><p><strong>Results: </strong>A higher CD34<sup>+</sup> cell dose was associated with inferior OS (P = 0.022) and increased NRM (P = 0.002), despite similar rates of graft failure and acute GVHD. Chronic GVHD was more frequent in the higher dose group, though the difference was not statistically significant. Multivariate Cox analysis confirmed a high CD34<sup>+</sup> cell dose as an independent predictor of poor OS (HR 2.054, P = 0.031).</p><p><strong>Conclusion: </strong>These findings suggest that excessively high doses may adversely affect survival by increasing transplant-related toxicity. Graft cell dose should be carefully balanced to optimize outcomes in haplo-PBSCT.</p>\",\"PeriodicalId\":46224,\"journal\":{\"name\":\"Blood Research\",\"volume\":\"60 1\",\"pages\":\"42\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331545/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Blood Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s44313-025-00091-5\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s44313-025-00091-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Impact of CD34+ cell dose on outcomes of haploidentical peripheral blood stem cell transplantation in acute leukemia.
Purpose: Allogeneic hematopoietic stem cell transplantation remains a curative option for acute leukemia. While an adequate CD34+ cell dose is essential for engraftment, the optimal upper threshold in haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) remains unclear.
Methods: We retrospectively analyzed 81 patients with acute leukemia who underwent haplo-PBSCT with reduced-intensity conditioning between 2010 and 2020. Patients were stratified by CD34+ cell dose (< 8 × 106/kg vs. ≥ 8 × 106/kg). Clinical outcomes, including overall survival (OS), non-relapse mortality (NRM), graft failure, and graft-versus-host disease (GVHD) incidence, were compared.
Results: A higher CD34+ cell dose was associated with inferior OS (P = 0.022) and increased NRM (P = 0.002), despite similar rates of graft failure and acute GVHD. Chronic GVHD was more frequent in the higher dose group, though the difference was not statistically significant. Multivariate Cox analysis confirmed a high CD34+ cell dose as an independent predictor of poor OS (HR 2.054, P = 0.031).
Conclusion: These findings suggest that excessively high doses may adversely affect survival by increasing transplant-related toxicity. Graft cell dose should be carefully balanced to optimize outcomes in haplo-PBSCT.
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