Zubair A, Zahrieh D, Daley H, Schott D, Gribben JG, Freedman A, Ritz J. Early neutrophil engraftment following autologous BMT provides a functional predictor of long-term hematopoietic reconstitution.
Transfusion 2003;
43:614-21. [PMID:
12702183 DOI:
10.1046/j.1537-2995.2003.00369.x]
[Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND
Previous studies have demonstrated that the number of CD34+ progenitor cells in the stem cell graft is highly predictive of the rapidity of short-term hematopoietic engraftment. The aim of this study was to identify factors that predict long-term hematopoietic reconstitution (LHR) following autologous BMT.
STUDY DESIGN AND METHODS
To identify predictors of LHR, peripheral blood counts and marrow biopsies were evaluated at 1 year after transplant in 81 patients with B-cell non-Hodgkin's lymphoma (NHL) or chronic lymphocytic leukemia who underwent autologous BMT. Results were correlated with CD34+ cell dose, granulocyte-monocyte colony-forming units (CFU-GM) infused, and time to neutrophil engraftment (TNE).
RESULTS
Total MNC dose, CD34+ cell dose, and CFU-GM infused were significantly associated with TNE (p = 0.011, p < 0.0001, and p = 0.078, respectively). Patients with chronic lymphocytic leukemia were more likely to have received a low CD34+ cell dose than patients with B-cell non-Hodgkin's lymphoma (p = 0.01). Among the four principal predictors, only TNE showed consistent significant correlation with WBC, absolute neutrophil, and platelet count at 1 year after transplant. Logistic regression model showed that TNE was a more sensitive predictor of LHR than either CD34+ cell dose or CFU-GM infused.
CONCLUSION
TNE is an in vivo functional measure of LHR and is a more sensitive predictor of LHR at 1 year after BMT than either CD34+ cell dose or CFU-GM infused.
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