CD34 + selected donor hematopoietic stem cell infusion for poor graft function after allogeneic hematopoietic stem cell transplantation: a retrospective cohort study
10.3760/cma.j.cn121090-20241120-00460
- VernacularTitle:纯化供者CD34 +造血干细胞输注治疗异基因造血干细胞移植后移植物功能不良的回顾性临床分析
- Author:
Shuo LIU
1
;
Qiang LI
;
Zhenyun LIU
;
Ruihui DU
;
Bin LIU
;
Zhaoyong MA
;
Erlie JIANG
;
Sizhou FENG
;
Jiali SUN
Author Information
1. 中国医学科学院血液病医院（中国医学科学院血液学研究所），血液与健康全国重点实验室，国家血液系统疾病临床医学研究中心，细胞生态海河实验室，天津 300020
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Poor graft function;
Donor purified CD34 + stem cells boost;
Hematopoietic reconstruction
- From:
Chinese Journal of Hematology
2025;46(10):921-928
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of purified donor CD34 positive hematopoietic stem cell (CD34 + cell) infusion in patients with poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods:The clinical data of 25 patients with PGF who underwent donor CD34 + cell sorting and infusion at the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences between September 2019 and March 2023, were retrospectively analyzed. The cohort included 19 haploidentical and 6 HLA-matched cases. CD34 + cells were purified using immunomagnetic beads for therapeutic infusion. The purification efficiency was evaluated based on the purity and recovery rate of CD34 + cells. Clinical outcomes were assessed by hematopoietic recovery, overall survival (OS) rate, and the incidence of graft-versus-host disease (GVHD) . Results:The median total number of CD34 + cells was 2.64 (0.82-6.53) × 10 8 before purification and 2.22 (0.48-5.68) ×10 8 after purification, with a median recovery rate of 78.37% (58.48%-115.72%) . After infusion of purified CD34 + cells, 8 of 10 patients (80.0%) with poor neutrophil engraftment achieved recovery (absolute neutrophil count ≥ 0.5×10 9/L) , with a median time to recovery of 21 (10-40) days. And 15 of 21 patients (71.4%) with poor platelet engraftment achieved recovery (platelet count ≥ 20×10 9/L) , with a median time to recovery of 15 (13-38) days. Only 3 patients (12.0%) developed GVHD after the infusion of purified CD34 + cells, including 2 cases of grade I acute GVHD and 1 case of limited chronic GVHD. With a median follow-up of 14.47 (0.23-41.63) months, the overall OS rate after CD34 + cell infusion was (65.63± 8.28) %. Seventeen patients survived, with a median survival time of 19.07 (0.23-41.63) months. Conclusion:Purification of CD34 + cells using immunomagnetic beads is effective, and the infusion of these purified donor CD34 + cells can safely and effectively improve PGF after allo-HSCT.
