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Article 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 reduced-intensity conditioning between 2010 and 2020. Patients were stratified by CD34 cell dose (< 8 × 10/kg vs. ≥ 8 × 10/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 transplant-related toxicity. Graft cell dose should be carefully balanced to optimize outcomes in haplo-PBSCT.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331545 | PMC |
| http://dx.doi.org/10.1007/s44313-025-00091-5 | DOI Listing |
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