Impact of CD34+ cell dose on outcomes of haploidentical peripheral blood stem cell transplantation in acute leukemia
10.1007/s44313-025-00091-5
- Author:
Haerim CHUNG
;
Hye Won KOOK
;
Hyunsoo CHO
;
Ji Eun JANG
;
June‑Won CHEONG
- Publication Type:RESEARCH
- From:Blood Research
2025;60():42-
- CountryRepublic of Korea
- Language:English
-
Abstract:
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 reducedintensity 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 trans‑ plant-related toxicity. Graft cell dose should be carefully balanced to optimize outcomes in haplo-PBSCT.
