Total nucleated cell dose in graft is a better prognostic factor for survival in pediatric patients transplanted with bone marrow compared to CD34+, CD3+, or total mononuclear cell count

KÜPELİ S., Inan G., Ozkan A., Sezgin G., Bayram I., Tanyeli A.

JOURNAL OF CLINICAL APHERESIS, vol.37, no.1, pp.19-24, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 37 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.1002/jca.21946
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.19-24
  • Keywords: allogeneic HSCT, children, engraftment, graft cell doses, survival, PERIPHERAL-BLOOD, IDENTICAL SIBLINGS, ENGRAFTMENT, IMPACT, MORTALITY, OUTCOMES, NUMBER, RISK
  • Çukurova University Affiliated: Yes


Background Most studies investigating the impact of graft composition on transplant-related outcomes have focused on the effect of CD34+ cell dose and reported equivocal results. The aim of this study is to investigate the impact of doses of total nucleated cells (TNCs), total mononuclear cells (TMCs), CD3+, and CD34+ cells on the outcome of children receiving allogeneic hematopoietic stem cell transplantation (HSCT). Methods Children and adolescents who underwent allogeneic HSCT for malignant hemato-oncological diseases or nonmalignant diseases in Cukurova University Faculty of Medicine, Pediatric Bone Marrow Transplantation Center between 2010 and 2020 were enrolled in the study. Results A total of 212 patients receiving allogeneic HSCT (154 bone marrow transplantation; 58 peripheral blood stem cell transplantation) from matched related or unrelated donors were included in the study. Higher TNC doses associated with a superior 5-year event-free survival (EFS; 67.7% vs 44.7%) in the whole group (log-rank P = .027). Overall survival (OS) and EFS of bone marrow-transplanted patients differed significantly according to TNC doses (log-rank P = .041 and .027, respectively). Multivariant analysis for OS revealed a P value of .038 for TNC, Exp(B) = 1.939 (95% CI: [1.038, 3.621]). That for EFS revealed a P value of .025 for TNC, Exp(B) = 1.992 (95% CI: [1.088, 3.647]). There was no relationship between doses of CD34+ cells, CD3+ cells, TMC, TNC, and neutrophil or platelet engraftment. Conclusion Our data suggest that TNC dose is a better prognostic factor for pediatric allogeneic HSCT outcomes than doses of CD34+ cells, CD3+ cells, or TMC in patients transplanted with bone marrow. Future studies analyzing cell subsets and other components in TNC could elaborate the factor(s) accompanying this observed survival advantage.