High CD34+ Cell Counts Decrease Hematologic Toxicity of Autologous Peripheral Blood Progenitor Cell Transplantation
Open Access
- 1 May 1998
- journal article
- Published by American Society of Hematology in Blood
- Vol. 91 (9), 3148-3155
- https://doi.org/10.1182/blood.v91.9.3148
Abstract
Optimal numbers of CD34+ cells to be reinfused in patients undergoing peripheral blood progenitor cell (PBPC) transplantation after high-dose chemotherapy are still unknown. Hematologic reconstitution of 168 transplantations performed in patients with lymphoproliferative diseases was analyzed according to the number of CD34+ cells reinfused. The number of days from PBPC reinfusion until neutrophil recovery (>1.0 × 109/L) and unsustained platelet recovery (>50 × 109/L) were analyzed in three groups defined by the number of CD34+ cells reinfused: a low group with less than or equal to 2.5 × 106 CD34+ cells/kg, a high group with greater than 15 × 106 CD34+cells/kg, and an intermediate group to which the former two groups were compared. The 22 low-group patients had a significantly delayed neutrophil (P < .0001) and platelet recovery (P < .0001). The 41 high-group patients experienced significantly shorter engraftment compared with the intermediate group with a median of 11 (range, 8 to 16) versus 12 (range, 7 to 17) days for neutrophil recovery (P = .003), and a median of 11 (range, 7 to 24) versus 14 (range, 8 to 180+) days for platelet recovery (P< .0001). These patients required significantly less platelet transfusions (P = .002). In a multivariate analysis, the amount of CD34+ cells reinfused was the only variable showing significance for neutrophil and platelet recovery. High-group patients had a shorter hospital stay (P = .01) and tended to need fewer days of antibotic administration (P = .12). In conclusion, these results suggest that reinfusion of greater than 15 × 106 CD34+ cells/kg after high-dose chemotherapy for lymphoproliferative diseases further shortens hematopoietic reconstitution, reduces platelet requirements, and may improve patients' quality of life.Keywords
This publication has 24 references indexed in Scilit:
- Imprecision of counting CFU-GM colonies and CD34-expressing cellsBone Marrow Transplantation, 1997
- Engraftment and outcomes of patients receiving myeloablative therapy followed by autologous peripheral blood stem cells with a low CD34+ cell contentBone Marrow Transplantation, 1997
- Relationship of CD34+ cell dose to early and late hematopoiesis following autologous peripheral blood stem cell transplantationBone Marrow Transplantation, 1997
- Daily Measurements of Blood CD34+ Cells After Stem Cell Mobilization Predict Stem Cell Yield and Posttransplant Hematopoietic RecoveryJournal of Hematotherapy, 1997
- HIGH‐DOSE THERAPY WITH PERIPHERAL BLOOD STEM CELL TRANSPLANTATION RESULTS IN A SIGNIFICANT REDUCTION OF THE HaEMOPOIETIC PROGENITOR CELL COMPARTMENTBritish Journal of Haematology, 1996
- Optimization of Peripheral Blood Stem Cell MobilizationThe International Journal of Cell Cloning, 1996
- Autologous Bone Marrow Transplantation as Compared with Salvage Chemotherapy in Relapses of Chemotherapy-Sensitive Non-Hodgkin's LymphomaNew England Journal of Medicine, 1995
- Haemopoietic reconstitution after autologous blood stem cell transplantation in patients with malignancies: a multicentre retrospective studyBritish Journal of Haematology, 1994
- Effect of peripheral-blood progenitor cells mobilised by filgrastim (G-CSF) on platelet recovery after high-dose chemotherapyThe Lancet, 1992
- Defining a Therapeutic Dose of Peripheral Blood Stem CellsJournal of Hematotherapy, 1992