Allogeneic hematopoietic transplantation of CD34+ selected cells from an HLA haplo-identical related donor.: A long-term follow-up of 135 patients and a comparison of stem cell source between the bone marrow and the peripheral blood

We studied the outcome of allogeneic transplants in 135 patients who received selected BM and/or PBSC CD34(+) cells from HLA haplo-identical related donors. Donor engraftment was achieved in 108 of 128 evaluable transplants. Engraftment failure? occurred more often in nonmalignant than in malignant diseases (10 of 25 vs 17 of 103, P = 0.010). The CD34(+) cell dose was associated with the speed of neutrophil and platelet recovery,but the cell source was not. Acute GVHD (greater than or equal to grade II) developed in 21.0 +/- 3.7%. Chronic GVHD occurred more frequently in malignancies than ill non-malignancies (44,1 +/- 7.6% vs 0.0%, P = 0.0075), and more in PBSC recipients than in BM recipients (53.6 +/- 9.4% vs 17.4 +/- 9.3%, P = 0,00541, Relapse rate was higher in high risk patients than in standard risk patients (78.7 +/- 7.1% vs 22.1 +/- 10.0%, P = 0.0001). Probabilities of disease-free survival (DFS) were 14.2 +/- 3.5% in malignancies and 25.7 +/- 9.2% in non-malignancies. Probabilities of DFS in standard and high risk patients were 39.4 +/- 9.2% and 5.7 +/- 2.8% (P = 0.0001). A high incidence of graft failure, infection and relapse was observed and resulted in high mortality.