Hematological recovery after autologous bone marrow transplantation in acute leukemia: predictive factors.
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.
Canals
C
C
Cryobiology and Cell Therapy Department, Hospital Clínic, Barcelona, Spain.
Marti
J M
JM
Martinez
E
E
Sierra
J
J
Punti
C
C
Granena
A
A
Domingo
A
A
Cubells
J
J
Brunet
S
S
Badell
I
I
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