Association of CD34 Cell Dose with 5-Year Overall Survival after Peripheral Blood Allogeneic Hematopoietic Cell Transplantation in Adults with Hematologic Malignancies

Timothy D. Gauntner, Claudio G. Brunstein, Qing Cao, Daniel J Weisdorf, Erica D Warlick, Najla El Jurdi, Joseph E. Maakaron, Mukta Arora, Brian C. Betts, Veronika Bachanova, Shernan G. Holtan, Fiona He

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Higher CD34 cell dose is associated with improved engraftment after peripheral blood allogeneic hematopoietic stem cell transplantation (alloHCT) but also may increase the risk of long-term complications, such as graft-versus-host disease (GVHD). Prior studies examining the relationship between CD34 cell dose and long-term survival outcomes have yielded conflicting results. In this study, we sought to clarify the prognostic impact of CD34 cell dose by examining a large contemporary cohort of patients undergoing alloHCT with a matched sibling peripheral blood stem cell (PBSC) donor. We retrospectively examined the impact of CD34 cell dose on overall survival (OS), neutrophil engraftment, platelet engraftment, treatment-related mortality, relapse, acute GVHD grade II-IV and III-IV, and chronic GVHD in 377 consecutive patients undergoing alloHCT with a PBSC graft source from a matched sibling donor at the University of Minnesota between 2002 and 2015. The patients were classified into 3 groups based on the tertile (T) of CD34 cell dose received: T1, <5 × 106 cells/kg; T2, 5 to 7.5 × 106 cells/kg; and T3, ≥7.5 × 106 cells/kg. Multivariable analysis demonstrated that high CD34 cell dose was associated with superior 5-year OS (hazard ratio [HR], 0.57; P = .01) and more rapid platelet engraftment (HR, 1.70; P < .01). Higher CD34 cell dose also was associated with improved absolute neutrophil count engraftment (T2: HR, 1.54; T3: HR, 1.52; P < .01). There was no association between CD34 cell dose and TRM or relapse at 5 years. Although higher CD34 cell dose was not associated with acute GVHD grade II-IV, it was associated with chronic GVHD (T2: HR, 1.68; T3: HR, 1.50; P = .04). Our data indicate that higher CD34 cell dose (>7.5 × 106/kg) is associated with superior OS at 5 years and improved engraftment but carries an increased risk of chronic GVHD. These data support a target CD34 cell dose goal of 7.5 × 106/kg for sibling PBSC graft donors.

Original languageEnglish (US)
Pages (from-to)88-95
Number of pages8
JournalTransplantation and Cellular Therapy
Issue number2
StatePublished - Feb 2022

Bibliographical note

Funding Information:
The authors thank the University of Minnesota Molecular and Cellular Therapy Laboratory for their contribution in processing and quantitating peripheral blood grafts for patients included in our study. Financial disclosure: This work was not supported by grant funding from any agency in the public, commercial, or not-for-profit sectors. Conflict of interest statement: There are no conflicts of interest to report. Financial disclosure: See Acknowledgments on page XXX.

Publisher Copyright:
© 2021


  • CD34
  • Cell dose
  • Matched sibling donor

PubMed: MeSH publication types

  • Journal Article


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