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CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study
Background PGF is historically associated with high morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Methods In this study, we report our multicenter experience on stem cell boost (SCB) for PGF, or incomplete donor engraftment, in 16 pediatric patients. D...
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| Published in: | Pediatric transplantation 2021-08, Vol.25 (5), p.e13909-n/a |
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| container_issue | 5 |
| container_start_page | e13909 |
| container_title | Pediatric transplantation |
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| creator | Berger, Massimo Faraci, Maura Saglio, Francesco Giardino, Stefano Ernestina Vassallo, Elena Prete, Arcangelo Fagioli, Franca |
| description | Background
PGF is historically associated with high morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT).
Methods
In this study, we report our multicenter experience on stem cell boost (SCB) for PGF, or incomplete donor engraftment, in 16 pediatric patients. Donors were HLA‐matched siblings (n = 4), unrelated donors (n = 11), or haploidentical family members (n = 1). Ten patients had two‐lineage cytopenia, 5 had one‐lineage cytopenia, and 1 had poor immunological reconstitution together with a low percentage of donor cell engraftment. A median of 6.6x106 selected CD34+/Kg was infused after 194 days from allo‐HSCT (48‐607).
Results
In 4 out of 5 patients, one‐lineage cytopenia was resolved, while among the 10 patients with two‐lineage cytopenia, 4 resolved both cytopenia, 5 resolved one‐lineage, and one did not respond. All patients reverted their mixed chimera to full donor chimera. OS was 56%, transplant‐related mortality (TRM) 32%, and RI 12%. The main causes of failure were related to infections with 4 out of 7 deaths caused by this.
Conclusions
SCB may rescue over 50% of patients with PGF after allo‐HSCT. An earlier treatment may reduce the infectious complications and improve survival. |
| doi_str_mv | 10.1111/petr.13909 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2457665669</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2555173045</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3579-8ac4b23a0450ca14f37d920cfbb05529de79e3e4ad2b6e2198189b7c3dc7fba3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhiMEoqVw4QHQSFy2QIodO8maG126C1IlVu3eI8eZaF0lcbAdYB-Vt2HSLRw44IPHmvn9zYz-JHnJ2QWn837E6C-4UEw9Sk4pqlQwWTy-f5ep4DI7SZ6FcMcYL-RSPk1OBCW5UuVp8mv1Sci3ELBDE7GBEb0d9-h1B3XnXAO3EXtYYdfBpXMhwuJ2dXkOrfOwdXRtvG4jrKfBROsGWGw363OgfG9_Es3sbU_A0IMdCN1YHb01MOpocYjhHdBn9LDHXkc3OouRqmHuaOaO0eshjJ0eop7pH-AGw9TFAK4FDZ7WdmGkue13hJ4K1hCVeCFOzeF58qTVXcAXD_Es2a2vdqvP6fXXzZfVx-vUiLxU6VIbWWdCM5kzo7lsRdmojJm2rlmeZ6rBUqFAqZusLjDjasmXqi6NaEzZ1lqcJYsjdvTu24QhVr0N8_R6QDeFKpN5WRR5USiSvv5HeucmP9BwVZbnOS_JtpxUb44qQ9sFj201ettrf6g4q2a_q9nv6t5vEr96QE51j81f6R-DScCPgh-2w8N_UNX2andzhP4Gt5m5Jw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2555173045</pqid></control><display><type>article</type><title>CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Berger, Massimo ; Faraci, Maura ; Saglio, Francesco ; Giardino, Stefano ; Ernestina Vassallo, Elena ; Prete, Arcangelo ; Fagioli, Franca</creator><creatorcontrib>Berger, Massimo ; Faraci, Maura ; Saglio, Francesco ; Giardino, Stefano ; Ernestina Vassallo, Elena ; Prete, Arcangelo ; Fagioli, Franca</creatorcontrib><description>Background
PGF is historically associated with high morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT).
Methods
In this study, we report our multicenter experience on stem cell boost (SCB) for PGF, or incomplete donor engraftment, in 16 pediatric patients. Donors were HLA‐matched siblings (n = 4), unrelated donors (n = 11), or haploidentical family members (n = 1). Ten patients had two‐lineage cytopenia, 5 had one‐lineage cytopenia, and 1 had poor immunological reconstitution together with a low percentage of donor cell engraftment. A median of 6.6x106 selected CD34+/Kg was infused after 194 days from allo‐HSCT (48‐607).
Results
In 4 out of 5 patients, one‐lineage cytopenia was resolved, while among the 10 patients with two‐lineage cytopenia, 4 resolved both cytopenia, 5 resolved one‐lineage, and one did not respond. All patients reverted their mixed chimera to full donor chimera. OS was 56%, transplant‐related mortality (TRM) 32%, and RI 12%. The main causes of failure were related to infections with 4 out of 7 deaths caused by this.
Conclusions
SCB may rescue over 50% of patients with PGF after allo‐HSCT. An earlier treatment may reduce the infectious complications and improve survival.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.13909</identifier><identifier>PMID: 33141997</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Antigens, CD34 - immunology ; CD34 antigen ; Child ; Child, Preschool ; Chimerism ; Donors ; Female ; Hematopoietic Stem Cell Transplantation ; Hematopoietic stem cells ; Histocompatibility antigen HLA ; Humans ; Infant ; Italy ; Leukemia - immunology ; Leukemia - therapy ; Leukopenia - immunology ; Leukopenia - therapy ; Male ; Morbidity ; Mortality ; Patients ; pediatric patients ; Pediatrics ; Peripheral blood ; Retrospective Studies ; stem cell boost ; Stem cell transplantation ; Transplantation Conditioning</subject><ispartof>Pediatric transplantation, 2021-08, Vol.25 (5), p.e13909-n/a</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><rights>2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3579-8ac4b23a0450ca14f37d920cfbb05529de79e3e4ad2b6e2198189b7c3dc7fba3</citedby><cites>FETCH-LOGICAL-c3579-8ac4b23a0450ca14f37d920cfbb05529de79e3e4ad2b6e2198189b7c3dc7fba3</cites><orcidid>0000-0002-7788-6407 ; 0000-0003-3455-3802 ; 0000-0001-5715-501X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33141997$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berger, Massimo</creatorcontrib><creatorcontrib>Faraci, Maura</creatorcontrib><creatorcontrib>Saglio, Francesco</creatorcontrib><creatorcontrib>Giardino, Stefano</creatorcontrib><creatorcontrib>Ernestina Vassallo, Elena</creatorcontrib><creatorcontrib>Prete, Arcangelo</creatorcontrib><creatorcontrib>Fagioli, Franca</creatorcontrib><title>CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>Background
PGF is historically associated with high morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT).
Methods
In this study, we report our multicenter experience on stem cell boost (SCB) for PGF, or incomplete donor engraftment, in 16 pediatric patients. Donors were HLA‐matched siblings (n = 4), unrelated donors (n = 11), or haploidentical family members (n = 1). Ten patients had two‐lineage cytopenia, 5 had one‐lineage cytopenia, and 1 had poor immunological reconstitution together with a low percentage of donor cell engraftment. A median of 6.6x106 selected CD34+/Kg was infused after 194 days from allo‐HSCT (48‐607).
Results
In 4 out of 5 patients, one‐lineage cytopenia was resolved, while among the 10 patients with two‐lineage cytopenia, 4 resolved both cytopenia, 5 resolved one‐lineage, and one did not respond. All patients reverted their mixed chimera to full donor chimera. OS was 56%, transplant‐related mortality (TRM) 32%, and RI 12%. The main causes of failure were related to infections with 4 out of 7 deaths caused by this.
Conclusions
SCB may rescue over 50% of patients with PGF after allo‐HSCT. An earlier treatment may reduce the infectious complications and improve survival.</description><subject>Adolescent</subject><subject>Antigens, CD34 - immunology</subject><subject>CD34 antigen</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chimerism</subject><subject>Donors</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Hematopoietic stem cells</subject><subject>Histocompatibility antigen HLA</subject><subject>Humans</subject><subject>Infant</subject><subject>Italy</subject><subject>Leukemia - immunology</subject><subject>Leukemia - therapy</subject><subject>Leukopenia - immunology</subject><subject>Leukopenia - therapy</subject><subject>Male</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patients</subject><subject>pediatric patients</subject><subject>Pediatrics</subject><subject>Peripheral blood</subject><subject>Retrospective Studies</subject><subject>stem cell boost</subject><subject>Stem cell transplantation</subject><subject>Transplantation Conditioning</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kcFu1DAQhiMEoqVw4QHQSFy2QIodO8maG126C1IlVu3eI8eZaF0lcbAdYB-Vt2HSLRw44IPHmvn9zYz-JHnJ2QWn837E6C-4UEw9Sk4pqlQwWTy-f5ep4DI7SZ6FcMcYL-RSPk1OBCW5UuVp8mv1Sci3ELBDE7GBEb0d9-h1B3XnXAO3EXtYYdfBpXMhwuJ2dXkOrfOwdXRtvG4jrKfBROsGWGw363OgfG9_Es3sbU_A0IMdCN1YHb01MOpocYjhHdBn9LDHXkc3OouRqmHuaOaO0eshjJ0eop7pH-AGw9TFAK4FDZ7WdmGkue13hJ4K1hCVeCFOzeF58qTVXcAXD_Es2a2vdqvP6fXXzZfVx-vUiLxU6VIbWWdCM5kzo7lsRdmojJm2rlmeZ6rBUqFAqZusLjDjasmXqi6NaEzZ1lqcJYsjdvTu24QhVr0N8_R6QDeFKpN5WRR5USiSvv5HeucmP9BwVZbnOS_JtpxUb44qQ9sFj201ettrf6g4q2a_q9nv6t5vEr96QE51j81f6R-DScCPgh-2w8N_UNX2andzhP4Gt5m5Jw</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Berger, Massimo</creator><creator>Faraci, Maura</creator><creator>Saglio, Francesco</creator><creator>Giardino, Stefano</creator><creator>Ernestina Vassallo, Elena</creator><creator>Prete, Arcangelo</creator><creator>Fagioli, Franca</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7788-6407</orcidid><orcidid>https://orcid.org/0000-0003-3455-3802</orcidid><orcidid>https://orcid.org/0000-0001-5715-501X</orcidid></search><sort><creationdate>202108</creationdate><title>CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study</title><author>Berger, Massimo ; Faraci, Maura ; Saglio, Francesco ; Giardino, Stefano ; Ernestina Vassallo, Elena ; Prete, Arcangelo ; Fagioli, Franca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3579-8ac4b23a0450ca14f37d920cfbb05529de79e3e4ad2b6e2198189b7c3dc7fba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Antigens, CD34 - immunology</topic><topic>CD34 antigen</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chimerism</topic><topic>Donors</topic><topic>Female</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Hematopoietic stem cells</topic><topic>Histocompatibility antigen HLA</topic><topic>Humans</topic><topic>Infant</topic><topic>Italy</topic><topic>Leukemia - immunology</topic><topic>Leukemia - therapy</topic><topic>Leukopenia - immunology</topic><topic>Leukopenia - therapy</topic><topic>Male</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Patients</topic><topic>pediatric patients</topic><topic>Pediatrics</topic><topic>Peripheral blood</topic><topic>Retrospective Studies</topic><topic>stem cell boost</topic><topic>Stem cell transplantation</topic><topic>Transplantation Conditioning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berger, Massimo</creatorcontrib><creatorcontrib>Faraci, Maura</creatorcontrib><creatorcontrib>Saglio, Francesco</creatorcontrib><creatorcontrib>Giardino, Stefano</creatorcontrib><creatorcontrib>Ernestina Vassallo, Elena</creatorcontrib><creatorcontrib>Prete, Arcangelo</creatorcontrib><creatorcontrib>Fagioli, Franca</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berger, Massimo</au><au>Faraci, Maura</au><au>Saglio, Francesco</au><au>Giardino, Stefano</au><au>Ernestina Vassallo, Elena</au><au>Prete, Arcangelo</au><au>Fagioli, Franca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2021-08</date><risdate>2021</risdate><volume>25</volume><issue>5</issue><spage>e13909</spage><epage>n/a</epage><pages>e13909-n/a</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>Background
PGF is historically associated with high morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo‐HSCT).
Methods
In this study, we report our multicenter experience on stem cell boost (SCB) for PGF, or incomplete donor engraftment, in 16 pediatric patients. Donors were HLA‐matched siblings (n = 4), unrelated donors (n = 11), or haploidentical family members (n = 1). Ten patients had two‐lineage cytopenia, 5 had one‐lineage cytopenia, and 1 had poor immunological reconstitution together with a low percentage of donor cell engraftment. A median of 6.6x106 selected CD34+/Kg was infused after 194 days from allo‐HSCT (48‐607).
Results
In 4 out of 5 patients, one‐lineage cytopenia was resolved, while among the 10 patients with two‐lineage cytopenia, 4 resolved both cytopenia, 5 resolved one‐lineage, and one did not respond. All patients reverted their mixed chimera to full donor chimera. OS was 56%, transplant‐related mortality (TRM) 32%, and RI 12%. The main causes of failure were related to infections with 4 out of 7 deaths caused by this.
Conclusions
SCB may rescue over 50% of patients with PGF after allo‐HSCT. An earlier treatment may reduce the infectious complications and improve survival.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33141997</pmid><doi>10.1111/petr.13909</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7788-6407</orcidid><orcidid>https://orcid.org/0000-0003-3455-3802</orcidid><orcidid>https://orcid.org/0000-0001-5715-501X</orcidid></addata></record> |
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| ispartof | Pediatric transplantation, 2021-08, Vol.25 (5), p.e13909-n/a |
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| subjects | Adolescent Antigens, CD34 - immunology CD34 antigen Child Child, Preschool Chimerism Donors Female Hematopoietic Stem Cell Transplantation Hematopoietic stem cells Histocompatibility antigen HLA Humans Infant Italy Leukemia - immunology Leukemia - therapy Leukopenia - immunology Leukopenia - therapy Male Morbidity Mortality Patients pediatric patients Pediatrics Peripheral blood Retrospective Studies stem cell boost Stem cell transplantation Transplantation Conditioning |
| title | CD34+ selected peripheral blood Stem Cell Boost (SCB) for Poor Graft Function (PGF) or mixed chimerism in pediatric patients, after hematopoietic stem cell transplantation: Results of a retrospective multicenter study |
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