CD34(+) immunoselected cells for poor graft function following allogeneic BMT

BackgroundPoor graft function without signs of graft rejection following allogeneic BMT (allo-BMT) occurs in around 9% of patients. A high incidence of hazardous complications may be encountered, leading to life-threatening situations.MethodsWe describe three patients who underwent allo-BMT for acute leukemia in first complete remission and untreated myelodysplastic syndrome. The three patients experienced prolonged and profound granulocytopenia, anemia and thrombocytopenia, despite growth factors and transfusions. This was not corrected by donor leukocytes infusion. They received a boost of CD34⁺ positively-selected cells from their HLA-identical sibling donors.ResultsA rapid improvement of peripheral blood cell counts was observed in both patients who were in full donor chimerism status at time of boost infusion, whereas the patient with mixed chimerism did not show any signs of improvement. Neither patient suffered further exacerbation of GvHD.DiscussionAllogeneic positively-immunoselected CD34⁺ cells can represent an interesting alternative treatment for poor graft function following allo- BMT, in the absence of graft rejection signs.