Klin Onkol 1998; 11(5): 163-167.
Summary: Background: Autologous peripheral blood stem cell transplantation (APBSCT) is gradually replacing autologous bone marrow transplantation in many indications. In this study we analyzed the relationship between hematopoietic reconstitution and patients and grafts characteristics. We focused on the relationship between engraftment and number of reinfused mononuclear cells (MNCs).
Design and Subject: Non-randomized single center study. Data of 95 APBSCT were analyzed.
Methods and Results: Peripheral stem cells were obtained after mobilization using chemotherapy with anti-neoplastic activity followed by Neupogen (G-CSF). After high dose chemotherapy and APBSCT, patients received Leucomax (GM-CSF). Patients were reinfused by (median, range) 2.06x108 (0.15-13.8) MNCs/kg. 6.1x106(0.83-29.3)CD34+ cells/kg, and 25.1x104 (1,0-167,0) CFU-GM/kg of body weight. The median time to engraftment was 12 days (both the for granulocytes >1x109/l and platelets >50x 109/l). We found a significant correlation between the number of CD34+ cells and CFU-GM reinfused and also between these characteristics of graft size and time to platelet, leukocyte and granulocyte recovery. We did not find (a significant correlation between number of MNCs reinfused and any other analyzed parameters (like age, diagnosis, number of previous chemotherapies, mobilization regimen, high dose regimen).
Conclusion: We conclude that the contents of progenitors in PBSC graft and time to both leukocyte and platelet recovery are best estimated by the number of CD34+ cells (not less than 1x106/kg is required) and CFU-GM (not less than 5x104/kg is required). The optimal numbers of these cells are about (wo times greater. The number of MNCs in graft is not suitable and useful for prediction of engraftment speed, even thoughit it is very simply measurable. There is probably no further benefit of rein-fusion of more than 5-8x106CD34+ cells/kg and/or 50x104 CFU-GM/kg, because hematopoietic recovery is not faster.
