High CD34‐positive cell dose in matched unrelated donor allogeneic hematopoietic stem cell transplant is not associated with graft‐versus‐host disease or mortality

• DOI: 10.1111/trf.17864
• Publication Date: 2024-05-02T02:49:35Z
• Authors: Zachary M. Avigan; Ajoy L. Dias; Laura E. Dodge; Jon E. Arnason; Robin M. Joyce; Jessica Liegel; Jacalyn Rosenblatt; Matthew J. Weinstock; David E. Avigan; Richard L. Haspel
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Abstract Background CD34+ stem cells serve as the primary graft source for allogeneic transplants, with a minimum of 2–4 × 10 6 cells/kg needed engraftment. There are conflicting data on outcomes at high cell doses, studies limited by few patients receiving doses far above target. Study design and Methods In this retrospective, single‐center study hematologic malignancies who underwent matched unrelated donor we assessed engraftment, survival, relapse, graft‐versus‐host disease (GVHD) highest dose quintile (>13 cells/kg, n = 36) compared to remaining ( 139). Similar analysis was performed correlating T outcomes. Results no difference between groups in neutrophil trend toward faster platelet significant mortality (adjusted risk ratio [aRR] 1.02, 95% confidence interval [CI] 0.85–1.22), relapse (aRR 1.10, CI 0.85–1.42), or overall survival Kaplan–Meier p .44). High not associated higher incidence acute GVHD 0.99 grades II–IV, aRR 1.18 III–IV) chronic 0.87 overall, RR 1.21 severe). correlation R 2 .073), there 33) quintiles 132). Discussion We found severity prior cutoffs reported literature. These do support routine use reduction.