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Autologous peripheral blood progenitor cell transplantation with <2 x 10(6) CD34(+)/kg: an analysis of variables concerning mobilisation and engraftment

Villalon, L.
Odriozola, J.
Larana, J. G.
Zamora, C.
Perez de Oteyza, J.
Jodra, M. H.
Lopez, J.
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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 AdolescentAdultAgedAntigens, CD34/analysisAntineoplastic Combined Chemotherapy Protocols/therapeutic useBlood Cell CountCaspase 14Caspases/administration & dosageCerebral Hemorrhage/etiologyCohort StudiesCombined Modality TherapyCyclophosphamide/administration & dosageCytarabine/administration & dosageErythropoietin/pharmacologyEtoposide/administration & dosageFemaleGraft SurvivalGranulocyte Colony-Stimulating Factor/pharmacologyHematologic Neoplasms/drug therapy/ therapyHematopoietic Stem Cell Mobilization/ methodsHematopoietic Stem Cell Transplantation/adverse effects/ methods/statistics &Numerical dataHumansHydroxyurea/administration & dosageInfection/etiology/mortalityLeukapheresis/methodsLife TablesMaleMiddle AgedNeoplasms/therapyProportional Hazards ModelsTransplantation Conditioning/adverse effects/methods/mortalityTransplantation, Autologous
PMID: 11920217
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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

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Deposited on : 2010-07-12

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