Autologous peripheral blood progenitor cell transplantation with <2 x 10(6) CD34(+)/kg: an analysis of variables concerning mobilisation and engraftment
|Published in||Hematology journal. 2000, vol. 1, no. 6, p. 374-381|
|Abstract||INTRODUCTION: This study analyses the factors affecting mobilisation and engraftment in autologous peripheral blood progenitor cell transplantation according to the number of CD34(+) re-infused. MATERIALS AND METHODS: A total of 190 patients underwent mobilisation with G-CSF alone (n=113) or in combination with chemotherapy (n=77). A total of 116 patients (61%) were autografted with <2 x 10(6) CD34(+) cells/kg and 74 patients were transplanted with >2 x 10(6) CD34(+) cells/kg. Rates of granulocyte and platelet recovery were estimated using the product-limit method of Kaplan-Meier and compared using a log-rank test. The Cox regression model was used for the multivariate analysis of factors influencing engraftment. Differences between cohorts were evaluated by one-way ANOVA or Mann-Whitney tests, and multivariate analysis was performed using a stepwise lineal regression. RESULTS: Neutrophil and platelet engraftment was significantly longer with <2 x 10(6)/CD34(+)/kg (12 vs 10 days, P=0.014 and 16 vs 13 days, P=0.0001 respectively). Platelet recovery was affected by exposure to alkylating agents (P=0.04), refractory disease (P=0.02) and AML (P=0.0001), but only the last two variables remained significant in Cox regression (P<0.01). Granulocyte engraftment was longer in CML (univariate, P=0.04) and in refractory disease (multivariate, P=0.02). In patients re-infused with >2 x 10(6)/CD34(+)/kg, the Cox model did not identify prognostic factors for haematopoietic recovery. CONCLUSION: Although mobilisation schedules and disease status influenced not only the yield of progenitor cells, but also the engraftment kinetics, the number of CD34(+) re-infused was the main predictor of haematopoietic recovery. While engraftment succeeded in most of the cases, the re-infusion of >2 x 10(6)/CD34(+)/kg resulted in significantly shorter recovery times.|
|Keywords||Adolescent — Adult — Aged — Antigens, CD34/analysis — Antineoplastic Combined Chemotherapy Protocols/therapeutic use — Blood Cell Count — Caspase 14 — Caspases/administration & dosage — Cerebral Hemorrhage/etiology — Cohort Studies — Combined Modality Therapy — Cyclophosphamide/administration & dosage — Cytarabine/administration & dosage — Erythropoietin/pharmacology — Etoposide/administration & dosage — Female — Graft Survival — Granulocyte Colony-Stimulating Factor/pharmacology — Hematologic Neoplasms/drug therapy/ therapy — Hematopoietic Stem Cell Mobilization/ methods — Hematopoietic Stem Cell Transplantation/adverse effects/ methods/statistics & — Numerical data — Humans — Hydroxyurea/administration & dosage — Infection/etiology/mortality — Leukapheresis/methods — Life Tables — Male — Middle Aged — Neoplasms/therapy — Proportional Hazards Models — Transplantation Conditioning/adverse effects/methods/mortality — Transplantation, Autologous|
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|VILLALON, L. et al. Autologous peripheral blood progenitor cell transplantation with <2 x 10(6) CD34(+)/kg: an analysis of variables concerning mobilisation and engraftment. In: Hematology journal, 2000, vol. 1, n° 6, p. 374-381. doi: 10.1038/sj/thj/6200057 https://archive-ouverte.unige.ch/unige:9268|