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Hematol J ; 1(6): 374-81, 2000.
Article in English | MEDLINE | ID: mdl-11920217

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.


Subject(s)
Hematologic Neoplasms/therapy , Hematopoietic Stem Cell Mobilization/methods , Hematopoietic Stem Cell Transplantation/methods , 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 , Hematopoietic Stem Cell Transplantation/adverse effects , Hematopoietic Stem Cell Transplantation/statistics & numerical data , Humans , Hydroxyurea/administration & dosage , Infections/etiology , Infections/mortality , Leukapheresis/methods , Life Tables , Male , Middle Aged , Neoplasms/therapy , Proportional Hazards Models , Transplantation Conditioning/adverse effects , Transplantation Conditioning/methods , Transplantation Conditioning/mortality , Transplantation, Autologous
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