Allogeneic peripheral blood progenitor cell transplantation: analysis of short-term engraftment and acute GVHD incidence in 33 cases. allo-PBPCT Spanish Group.
The results of 33 allogeneic peripheral blood progenitor cells transplants (allo-PBPCT) in adult patients with hematologic malignancies were analyzed in a retrospective and multicenter study. In 21 of 33 cases (63%) the disease was refractory or in advanced stage and eight of the 33 cases (24%) were second transplants after relapse. Donors were treated with a median of 10 (4-16) micrograms/kg/day of rhG-CSF subcutaneously for 5-7 days. Three required a central venous line for harvesting. Peripheral blood leukapheresis product contained a median of 5.9 (1.8-13) 10(6)/kg CD34+ cells and a median of 309.5 (153-690) 10(6)/kg CD3+ cells. After a myeloablative regimen, all patients received PBPC from HLA-identical donors as the sole source of progenitor cells. Cyclosporin A (CsA) alone (n = 2), CsA and steroids (n = 9), and CsA and methotrexate (MTX) (n = 22) were used for GVHD prophylaxis. Growth factors post-transplant were given to 11 patients (33%). The median follow-up of the patients was 3 months. Actuarial median day for hemopoietic recovery was: neutrophils to >0.5 (>1) x 10(9)/l, day 14 (15); platelets to >20 (>50) x 10(9)/l, day 14 (21). The quantity of CD34+ cells infused did not significantly affect the engraftment kinetics, from a starting cutoff of 2.5 x 10(6)/kg. The speed of neutrophil recovery seemed to be influenced strongly by using rhG-CSF post-transplant and marginally by the type of GVHD prophylaxis. Actuarial probability for grade II-IV acute GVHD of the whole group was 37% (95% Cl, 20-54%).
Urbano-Ispizua
A
A
Hospital Clinic, Barcelona, Spain.
Solano
C
C
Brunet
S
S
Hernández
F
F
Sanz
G
G
Alegre
A
A
Petit
J
J
Besalduch
J
J
Vivancos
P
P
Díaz
M A
MA
Moraleda
J M
JM
Carreras
E
E
Ojeda
E
E
de la Rubia
J
J
Benet
I
I
Domingo-Albós
A
A
García-Conde
J
J
Rozman
C
C
D000206:Actuarial Analysis; D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001853:Bone Marrow / Q000187:drug effects; D002405:Catheterization, Central Venous; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D000069585:Filgrastim; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology*; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D000078224:Lenograstim; D007937:Leukapheresis / Q000295:instrumentation / Q000379:methods; D007958:Leukocyte Count; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009504:Neutrophils; D010976:Platelet Count; D011994:Recombinant Proteins / Q000494:pharmacology; D019233:Retreatment; D012189:Retrospective Studies; D012449:Safety; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim; D016572:Cyclosporine; D000069585:Filgrastim; D008727:Methotrexate