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

Background Poor graft function without signs of graft rejection following a llogeneic BMT (allo-BMT) occurs in around 9% of patients A high incidence o f hazardous complications may be encountered lending to life-threatening si tuations Methods We describe three patients who underwent allo-BMT for acute leukemi a in first complete remission and untreated myelodysplastic syndrome. The t hree patients experienced prolonged and profound granulocytopenia, anemia a nd thrombocytopenia, despite growth factors and transfusions. This was not corrected by donor leukocytes infusion. They received a boost of CD34(+) po sitively-selected cells from their HLA-identical sibling donors. Results A rapid improvement of peripheral blood cell counts was observed in both patients who were in full donor chimerism status at time of boost inf usion, whereas the patient with mixed chimerism did not show any signs of i mprovement Neither patient suffered further exacerbation of GVHD. Discussion Allogeneic positively-immunoselected CD34(+) cells can represent an interesting alternative treatment for poor graft function following all owing BMT, in the absence of graft rejection signs.