Korean J Hematol.  2007 Dec;42(4):301-308. 10.5045/kjh.2007.42.4.301.

Influential Factors for Engraftment in Autologous Peripheral Hematopoietic Stem Cell Transplantation (APBSCT)

• Jeung KJ
• Kang MS
• Kwon KD
• Kim KH
• Lee JC
• Lee SC
• Kim HJ
• Bae SB
• Kim CK
• Lee NS
• Lee KT
• Park SK
• Won JH
• Hong DS
• Park HS

• KMID: 2252214
• DOI: http://doi.org/10.5045/kjh.2007.42.4.301

Abstract

BACKGROUND: Autologous peripheral hematopoietic stem cell transplantation (APBSCT) has been widely used to treat various types of hematological disorders, metabolic diseases and congenital immunodeficiency. Hematopoietic recovery is important because prolonged duration of neutropenia and thrombocytopenia is associated with a higher risk of infection, bleeding and treatment related mortality. Many investigators have studied the factors that affect hematopoietic recovery after stem cell transplantation.
METHODS
We retrospectively investigated the factors influencing hematopoietic engraftment in 112 patients with hematological malignancies and solid tumors who received APBSCT. We evaluated the gender, age, CD34+ cell number, conditioning regimens, and the type of tumor and their association with neutrophil and platelet engraftment.
RESULTS
Post-transplant neutrophil engraftment (>500/microL) required a median of 11 days (range 6~50) and platelet engraftment 12 (range 1~78) days (>20,000/microL). The univariate analysis showed that the factors that positively affected hematopoietic recovery were: the type of conditioning regimens such as BEAM (BCNU, etoposide, cytosine arabinoside, melphalan) and BEAC (BCNU, etoposide, cytosine arabinoside, cyclophosphamide) versus BC (busulfan, cyclophosphamide), the CD34+ cell number and the disease diagnosis such as multiple myeloma versus acute myelogenous leukemia. The multivariate analysis showed only the CD34+ cell number (5~10 x 10(6)/kg) to be significantly associated with early neutrophil and platelet engraftment (P<.001).
CONCLUSION
These findings suggest that measurement of the CD34+ cell count may be sufficient to predict the time to engraftment after APBSCT.

Keyword

Engraftment; Autologous; Stem cell transplantation

MeSH Terms

Blood Platelets
Cell Count
Cytarabine
Diagnosis
Etoposide
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Hemorrhage
Humans
Leukemia, Myeloid, Acute
Metabolic Diseases
Mortality
Multiple Myeloma
Multivariate Analysis
Neutropenia
Neutrophils
Research Personnel
Retrospective Studies
Stem Cell Transplantation
Thrombocytopenia
Cytarabine
Etoposide

Figure

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  Fig. 1 Analysis of the correlation between CD34+ cell dose and engraftment in Auto PBSCT illustrate that infused CD34+ cell/kg is significantly correlated with the time to neutrophil and platelet engraftment.

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  Fig. 2 Kaplan-Meier cumulative probability curves illustrate CD34+ cell number (＞5.0×106/kg) is significantly associated with neutrophil and platelet engraftment in APBSCT (P＜.001).

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