[English]  [Pусский]  [中文]  
 
ctt-journal > Chernyavskaya T.2 et al. (Abstract)

Chernyavskaya T.2 et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract43

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

Contribute a comment

 

Using stimulated bone marrow as a source of hematopoietic stem cells for allogeneic transplantation

Tatiana Z. Chernyavskaya, Sergey N. Abdusalamov, Ludmila U. Grivtsova, Kapitolina N. Melkova, Nikolay N. Tupitsyn

N.N. Blokhin Cancer Research Center, RAMS, Moscow, Russia

Correspondence: Tatiana Z. Chernyavskaya, N.N. Blokhin Cancer Research Center, 23, Kashirskoe sh., Moscow, Russia, E-mail: 9067552930@spam is badmail.ru

Abstract

Selecting hematopoietic stem cell (HSC) sources for transplantation depends on the specific nature of the underlying disease and its stage, clinical protocol, the presence of contraindications for specific source used; and the body weight of both donor and recipient.

This study aimed to develop tactics to obtain an adequate amount of quality material for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with a potential risk of "graft-versus-host-disease" (GVHD) reaction.

Between August 2006 and June 2011 bone marrow (BM) was harvested from 16 healthy donors (9 women, 7 men) aged from 15 to 69 years (median 32), including 14 cases with G-CSF stimulated BM (at a dose of 10 mg/kg/day).

In all cases BM harvest was successful with nucleated cells (NC) 5.45 x108/kg body weight (range 1.73–16.76), CD34 + cells 1.64 x106/kg (0.53–7.54), CD3+ cells 3.1 x107/kg (0.59–4.6), GM-CFU 9.8 x104/kg (3.9–57.3). AlloBMT was performed in 16 patients (5 women and 11 men, median age 27y, range, 17–53). Most patients (15, 93.75%) had leukemia, including 3 cases with progression; and all received myeloablative conditioning (busulfan/cyclophosphamide: 8 cases, containing a total body irradiation: 7). One patient with multiple myeloma (MM) received non-myeloablative conditioning.

Neutrophil recovery >0.5 x 109/l was observed at D+18 (D+13–D+35) and platelet counts >50 x 109/l at D+18 (D+12–D+46). The 100-day transplant-related mortality rate was 6.25%, and the cause of death of patient with MM was severe acute GVHD stage IV, refractory to steroids. None of the 11 patients without leukemia progression GVHD developed fatal GVHD. Acute GVHD stage III–IV developed in 3 cases (18.75%), and extensive chronic GVHD was observed in 4 patients (25%). Restoration of the CD4 + T-lymphocytes level >0.1 x 109/l at D+200 was observed in 60% of cases and correlated with the severity of GVHD and the frequency of infectious episodes. Relapse-free survival at 2 years was 56.25%. One patient developed relapse at D+167.

Thus, allo-HSCT with stimulated BM, which contains significantly fewer T cells compared with PBSC, reduces the risk of severe refractory GVHD.

Keywords: allogeneic bone marrow transplantation, stimulated bone marrow