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Related Experiment Videos

CD34 augmentation improves allogeneic T cell-depleted bone marrow engraftment

S J Noga1, A Seber, J M Davis

  • 1Johns Hopkins Oncology Center, Baltimore, MD 21287, USA.

Journal of Hematotherapy
|May 23, 1998
PubMed
Summary
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Reinfusing small CD34+ cells lost during T cell depletion (TCD) in bone marrow transplantation (BMT) improves engraftment kinetics. This strategy enhances stem cell dose, safely overcoming TCD-related graft failure and delayed engraftment.

Area of Science:

  • Hematology
  • Transplantation Immunology
  • Cellular Therapy

Background:

  • T cell depletion (TCD) via elutriation reduces graft-versus-host disease (GvHD) after bone marrow transplantation (BMT).
  • However, TCD can lead to graft failure, delayed engraftment, and mixed chimerism due to loss of essential CD34+ cells.
  • Significant proportions of CD34+ cells are lost with small lymphocytes during elutriation.

Purpose of the Study:

  • To assess if reinfusing lost small CD34+ cells improves engraftment kinetics after TCD in BMT.
  • To evaluate the safety and efficacy of augmenting the stem cell dose by adding back these cells.
  • To determine if this approach mitigates TCD-associated complications.

Main Methods:

  • A phase I trial was conducted using HLA-identical siblings undergoing BMT.

Related Experiment Videos

  • CD34+ cells were isolated from the small cell fraction of donor grafts.
  • These isolated CD34+ cells were reinfused with the TCD graft.

    • Main Results:

    • Reinfused product was 80% CD34+, doubling the graft's CD34+ content.
    • All patients achieved prompt engraftment, with median times of 19 days for neutrophils, 24 days for platelets, and 24 days for hospital discharge.
    • Only 2 patients experienced acute GvHD, and no chronic GvHD was observed.

    Conclusions:

    • Augmenting the stem cell dose by reinfusing lost CD34+ cells is an effective strategy.
    • This method safely overcomes delayed engraftment and graft failure associated with TCD.
    • It offers an alternative to increasing immunosuppression in BMT recipients.