Donor marrow progenitors (CFU-Mix, BFU-E and CFU-GM) and haemopoietic engraftment following HLA matched sibling bone marrow transplantation.
Bone marrow multipotent (CFU-Mix) and unipotent (CFU-GM and BFU-E) progenitor cells in the donor marrow inoculums were measured in 24 histocompatible sibling bone marrow transplants. The number of donor marrow nucleated cells, CFU-Mix, CFU-GM and BFU-E given per kilogram (kg) of recipient's body weight were 2.4 +/- 0.6 X 10(8), 3.6 +/- 4.2 X 10(3), 4.9 +/- 3.3 X 10(-4) and 4.3 +/- 4.1 X 10(4) respectively (mean +/- S.D.). Fast engraftment patients, as assessed by rise in peripheral blood neutrophils (greater than or equal to 0.5 and greater than or equal to 1.0 X 10(9)/l) and platelets (greater than 20 and greater than 50 X 10(9)/l), received a significantly greater amount of CFU-Mix/kg (greater than 3 X 10(3)/kg, p less than 0.025) and CFU-GM/kg (greater than 3 X 10(4)/kg, p less than 0.05 except for plat greater than or equal to 20 X 10(9)/l) than the slow recovery patients. Significant correlations were found between the donor CFU-Mix/kg infused and neutrophil recovery to 1 X 10(9)/l and platelet to 50 X 10(9)/l (Spearman's rank correlation coefficient r = 0.38, p = 0.04 and r = 0.58, p = 0.003, respectively). The amount of donor CFU-GM/kg given also correlated significantly to neutrophil (1 X 10(9)/l) and platelet (50 X 10(9)/l) recovery, (r = 0.33 and r = 0.37, respectively, p less than or equal to 0.05). There was no association between BFU-E, and marrow nucleated cells infused per kg and haemopoietic recovery. A number of clinical parameters were also examined to determine other factors that may influence the rate of engraftment. Acute graft vs host disease (greater than or equal to grade II) and methotrexate therapy post-transplant delayed the platelet regeneration. The results of the present report indicate that in vitro measurement of donor CFU-Mix and CFU-GM progenitors infused, correlate with the speed of granulocyte and platelet recovery in clinical allogeneic bone marrow transplants.
D001788:Blood Grouping and Crossmatching; D001792:Blood Platelets / Q000187:drug effects; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D003114:Colony-Forming Units Assay; D006086:Graft vs Host Disease / Q000276:immunology; D006680:HLA Antigens / Q000032:analysis*; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000276:immunology*; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use
D006680:HLA Antigens; D008727:Methotrexate