The level of peripheral blood circulating CD34+ cells is higher in acute promyelocytic leukemia patients with adverse prognostic factors.

INTRODUCTION: The increased flow cytometry enumeration of peripheral blood circulating CD34+ cells in patients with acute leukemia has been found in our previous work. In this study, we also demonstrated that acute promyelocytic leukemia (APL) patients not only had elevated CD34+ cell count, but also had some clinical features. METHODS: Fifty APL patients and 19 healthy volunteers were included in the study. The enumeration of circulating CD34+ cells, cytogenetic subgroup, immunophenotype analysis, and leukemic-related gene mutation detection were performed. RESULTS: Some APL patients with higher count of CD34+ cells (≤10 × 10(6)/l) usually possessed one or more poor prognostic factors (higher WBCs count, PML/RARa gene complex fusion, chemotherapy-related APL, normal karyotype/complex karyotype abnormalities, CD56/CD34 antigen positive expression, FLT3-ITD positive mutation, myelofibrosis, and marrow necrosis). A cut-off value of 10 × 10(6)/l CD34+ cells may have the power to distinguish APL patients with above adverse clinical prognostic factor from other APL subjects. CONCLUSION: The circulating CD34+ cell count appears to increase in some APL patients and a higher CD34+ cell count may be indicative of inferior survival and serve as an adverse biomarker for APL.

[A clinical study of 31 patients with malignant hematopoietic disease treated with non-T cell-depleted HLA-haploidentical hematopoietic stem cell transplantation].

OBJECTIVE: To investigate the effects and prognosis of malignant hematological disease after HLA haploidentical hematopoietic stem cell transplantation (H-HSCT) without T-cell depletion. METHODS: The clinical data of 31 cases with malignant hemopoietic disease treated with H-HSCT from July 2002 to July 2006 were analyzed, including 11 cases of standard risk and 20 of high risk. RESULTS: 30 patients achieved engraftment of a median of 13 and 22 days for neutrophil and platelet, with an accumulative incidence of II - IV grade acute graft-versus-host disease (GVHD) 61.3%, and an accumulative incidence of chronic GVHD 41.9%. 13 patients survived with Karnofsky scale over 90.0% after a median follow-up of 24 months. 33 months of accumulative survival was 62.3% in the standard risk group and 35.0% in the high risk group. The CD(3)(+) T cells count of the graft and the disparity of HLA-A, B, DR loci were the major factors of impact on acute GVHD. CONCLUSION: HLA H-HSCT is an effective therapeutic method for malignant hematological disease, CD(3)(+) T cells count of the graft and the disparity of HLA-A, B, DR loci are the major factors of impact on acute GVHD.