{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:29:08Z","timestamp":1784744948083,"version":"3.55.0"},"reference-count":47,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Cancer Institute\/National Institutes of Health","award":["P01-CA078902"],"award-info":[{"award-number":["P01-CA078902"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P01-CA018029"],"award-info":[{"award-number":["P01-CA018029"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P30-CA015704"],"award-info":[{"award-number":["P30-CA015704"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["T32-HL007093"],"award-info":[{"award-number":["T32-HL007093"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P01-CA078902"],"award-info":[{"award-number":["P01-CA078902"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P01-CA018029"],"award-info":[{"award-number":["P01-CA018029"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P30-CA015704"],"award-info":[{"award-number":["P30-CA015704"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["T32-HL007093"],"award-info":[{"award-number":["T32-HL007093"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P01-CA078902"],"award-info":[{"award-number":["P01-CA078902"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P01-CA018029"],"award-info":[{"award-number":["P01-CA018029"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["P30-CA015704"],"award-info":[{"award-number":["P30-CA015704"]}]},{"name":"National Cancer Institute\/National Institutes of Health","award":["T32-HL007093"],"award-info":[{"award-number":["T32-HL007093"]}]},{"name":"NIH\/National Heart, Lung, and Blood Institute","award":["P01-CA078902"],"award-info":[{"award-number":["P01-CA078902"]}]},{"name":"NIH\/National Heart, Lung, and Blood Institute","award":["P01-CA018029"],"award-info":[{"award-number":["P01-CA018029"]}]},{"name":"NIH\/National Heart, Lung, and Blood Institute","award":["P30-CA015704"],"award-info":[{"award-number":["P30-CA015704"]}]},{"name":"NIH\/National Heart, Lung, and Blood Institute","award":["T32-HL007093"],"award-info":[{"award-number":["T32-HL007093"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The impact of donor graft cell composition on post-HCT outcomes in AML remains controversial. Furthermore, it is unknown whether this interacts with pre-HCT MRD status. We evaluated the impact of CD34+ and CD3+ cell doses on outcomes of myeloablative conditioning (MAC) HCT in patients with myelodysplastic neoplasm (MDS)\/AML or AML with and without detectable MRD in pre-HCT bone marrow specimens. Methods: We utilized an electronic database to identify all adults \u226518 years with MDS\/AML or AML who underwent MAC and received 10\/10 HLA-matched sibling or unrelated donor mobilized PBSC allografts in first morphologic remission between 2006 and 2023 at the University of Washington\/Fred Hutchinson Cancer Center. Results: Among 385 adults, we found a progressive decrease in relapse incidence and improved survival with increasing CD34+ doses up to a threshold of 5.61 \u00d7 106\/kg, above which the relapse risk no longer decreased. After multivariable adjustment, a low CD34+ dose was associated with increased risk of relapse as well as lower overall and relapse-free survival. Similar results were obtained for patients with and without pre-HCT MRD. Higher CD3+ doses were linearly associated with an increased incidence of moderate\u2013severe chronic GVHD. Conclusions: Our data identify a non-linear relationship between CD34+ cell dose and relapse risk in AML patients undergoing myeloablative allogeneic HCT, with no apparent added benefit beyond a CD34+ dose threshold. Our findings suggest that donor graft composition impacts outcomes in adults with AML undergoing allogeneic HCT after MAC, independent of pre-HCT MRD status; however, additional studies are needed for other donor cell scenarios.<\/jats:p>","DOI":"10.3390\/cancers17142323","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T07:54:23Z","timestamp":1752479663000},"page":"2323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["CD34+ Cell Dose, Measurable Residual Disease, and Outcome After Myeloablative HLA-Matched Peripheral Blood Hematopoietic Cell Transplantation for Adults with Acute Myeloid Leukemia"],"prefix":"10.3390","volume":"17","author":[{"given":"Margery","family":"Gang","sequence":"first","affiliation":[{"name":"Hematology\/Oncology Fellowship Program, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8176-6371","authenticated-orcid":false,"given":"Megan","family":"Othus","sequence":"additional","affiliation":[{"name":"Public Health Science Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Chloe","family":"Olix","sequence":"additional","affiliation":[{"name":"Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate A.","family":"Markey","sequence":"additional","affiliation":[{"name":"Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"},{"name":"Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4151-3171","authenticated-orcid":false,"given":"Derek L.","family":"Stirewalt","sequence":"additional","affiliation":[{"name":"Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"},{"name":"Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9646-6216","authenticated-orcid":false,"given":"Laura S.","family":"Connelly-Smith","sequence":"additional","affiliation":[{"name":"Public Health Science Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"},{"name":"Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2600-6390","authenticated-orcid":false,"given":"Stephanie J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Public Health Science Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"},{"name":"Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Milano","sequence":"additional","affiliation":[{"name":"Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"},{"name":"Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9268-3341","authenticated-orcid":false,"given":"Roland B.","family":"Walter","sequence":"additional","affiliation":[{"name":"Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA"},{"name":"Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA 98109, USA"},{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Loke, J., Vyas, H., and Craddock, C. 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