Relación entre la cantidad de células progenitoras CD133+ con el tiempo de injerto en el trasplante alogénico

Abstract

ABSTRACT: The mobilization of hematopoietic stem cells into the circulation has improved the efficiency of their collection. Transplantation of movilized blood stem cells to patients with different haematologic diseases results in a faster pace of hematopoietic recovery than transplantation of marrow derived stem cells. Quantification of CD34+ mononuclear cells is the most important quality control measure for hematopoietic stem cell (HSC) transplantation. A fraction of CD34+ cells also expressed the CD133 antigen. These cells constituted a group of earlier, less-differentiated HSCs with a potentially higher capacity for engraftment. The total number of CD34+ cells peripheral HSCs and the fraction of these cells that coexpressed CD133+ was determined before and after automated collection by leukapheresis, as well as the effect of HSC CD133+ dose on hematopoiesis recovery. In this work loocked the relation between the quantity of progenitor cells CD133+ with the period of graft in the allogeneic transplant. STUDY DESIGN AND METHODS: Granulocyte-colony-stimulating factor mobilization of HSCs from the bone marrow to the peripheral blood (PB) of allogeneic donors was followed by automated collection through leukapheresis on the fifth day. Quantification of CD34+, CD38+ and CD133+ cells was performed on PB before collection and in the hematopoietic graft by flow cytometry. RESULTS: Twenty six patients with different haematologics disease were studied. The average age was 37 years. The cell colonies CD34+38-, 34+38+, 34+133-, 133+38-, 133+38+, 133+34-, 133+34+ were determined in basal samples collected from patients and donators, mobilized and donor’s harvest. There was a significant difference after the mobilization in all the cellular population. The average dosis of CD34+ infused was 8.9666 cells X106/kg and 5.885 cells X106/kg of CD133+. With this dosis of CD34+ neutrophils were grafted on the thirteenth day, platelets and reticulocytes on the fourteenth. Patients that received a dosis of 8.966 cells X106/kg of CD34+ showed death (P=0.077). The presence of graft versus host disease (GVHD) was higher with high dosis of implated stem cell. The GVHD type I and II were the most frequent among 35% of the patients. The middle of overall survival was of 363 days postransplant in average and 295 days of free of disease survival. CONCLUSION: A significant mobilization of pheripherical blood was obtained from all the population analized using G-CSF with a dosis of 10 μg/kg/day was administered subcutaneously for five consecutive days. With the average infused dosis of CD34+=8.966 cells X106/kg and of CD133+ =5.885 cells X106/kg., the graft was for the myeloid, platelets and erythroid series was gotten between the 12 and the 14 day. However, it was found that the dosis did not have any influence with the period of the graft. With minor dosis of 7.2 cells X106/kg of CD34+, 64% of the patients did not present GVHD and the other 36% presented only the types I and II. With dosis less than 3.0 cells X106/kg of CD133+, it was found that 67% of the patients did not present GVHD and the other 33% presented GVHD type I, II and III. Regarding the overall survival, a medium of 363 days was obtained and for the free of disease survival it was 295 days.

RESUMEN: La movilización de células tallo hematopoyéticas dentro de la circulación sanguínea ha mejorado la eficiencia de su colección. El trasplante de células tallo movilizadas para pacientes con diferentes enfermedades hematológicas resulta un paso rápido para la recuperación hematopoyética que deriva de células tallo de médula trasplantada. La cuantificación de células mononucleares CD34+ es la medida más importante de control de calidad para el trasplante de células tallo hematopoyética (CTH). Estas células constituyen un grupo primitivo de células tallo menos diferenciadas, con una potencial y elevada capacidad de injerto. La cantidad total de células tallo hematopoyéticas periféricas CD34+ y la fracción de estas células que coexpresan CD133+, fue determinado antes y después de la colección automatizada por leucoaféresis, así como el efecto de la dosis de las células tallo CD133+.en la recuperación hematopoyética En este trabajo se observó la relación entre la cantidad de células progenitoras CD133+ con el periodo de injerto en el trasplante alogénico.