title: Hematological recovery after autologous bone marrow transplantation in acute leukemia: predictive factors.
abstract: The kinetics of hematological recovery after autologous marrow transplantation have been studied in 70 patients with acute leukemia (38 acute nonlymphoblastic leukemia [ANNL] and 32 acute lymphoblastic leukemia [ALL]). The incidence of graft failure in this group was 3.2%, and a persistent severe thrombocytopenia was observed in 24% of the cases. Variables influencing engraftment have been studied using univariate and multivariate statistical analysis. Analysis of the entire group showed a correlation between graft colony-forming unit granulocyte-macrophage (CFU-GM) content and granulocyte recovery (p < 0.001). Marrow purging was associated with a delayed engraftment (p < 0.001). In ANLL patients, we found that high cummulated AraC doses before marrow cryopreservation correlated with poor granulocyte recovery after marrow infusion (p < 0.002). Platelet recovery was essentially affected by age, with shorter thrombocytopenia periods in younger patients (p < 0.001). Finally, excluding autotransplants with purged marrows, ALL patients showed better platelet recoveries than ANLL patients (p < 0.005). These findings will be useful to evaluate the risk of delayed engraftment after autologous bone marrow transplantation (ABMT) in patients with acute leukemia.
authors.affiliation: Cryobiology and Cell Therapy Department, Hospital Clínic, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Canals
authors.forename: J M
authors.initials: JM
authors.lastname: Marti
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.forename: C
authors.initials: C
authors.lastname: Punti
authors.forename: A
authors.initials: A
authors.lastname: Granena
authors.forename: A
authors.initials: A
authors.lastname: Domingo
authors.forename: J
authors.initials: J
authors.lastname: Cubells
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.forename: I
authors.initials: I
authors.lastname: Badell
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016465:Bone Marrow Purging / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002675:Child, Preschool; D003114:Colony-Forming Units Assay; D003131:Combined Modality Therapy; D015925:Cryopreservation; D005260:Female; D006085:Graft Survival; D006410:Hematopoiesis; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D013921:Thrombocytopenia / Q000209:etiology; D017211:Treatment Failure; D016896:Treatment Outcome