High-dose therapy with peripheral blood stem cell transplantation results in a significant reduction of the haemopoietic progenitor cell compartment.
In order to study the effect of high-dose therapy with peripheral blood stem cell transplantation (PBSCT) on the haemopoietic reserve in man, the number and composition of bone marrow (BM) and peripheral blood (PB)-derived progenitor cells were examined in 137 cancer patients. In 45 patients, paired samples from BM and PB were obtained before PBSC mobilization and 6-27 months after transplantation. Following PBSCT. the proportion of CD34+ cells was significantly smaller than before mobilization (BM 1.99 +/- 0.24 versus 0.8 +/- 0.09, P < 0.001), and no change was observed at several follow-up visits thereafter. The reduction was most pronounced for the primitive BM progenitor subsets such as the CD34+/DR- and CD34+/ Thy-1+ cells. The impairment of hematopoiesis was also reflected by a significant reduction in the plating efficiency of BM and PB samples. No relationship was found between the decrease in the proportion of CD34+ cells and any particular patient characteristics, kind of high-dose therapy or the CD34+ cell content in the autograft. In conclusion, high-dose therapy with PBSC transplantation is associated with a long-term impairment of the haemopoietic system. The reduction in the number of haemopoietic progenitor cells is not associated with a functional deficit, as peripheral blood counts post-transplantation were normal in the majority of patients.
Voso
M T
MT
Department of Internal Medicine V, University of Heidelberg, Germany.
Murea
S
S
Goldschmidt
H
H
Hohaus
S
S
Haas
R
R
D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D019337:Hematologic Neoplasms / Q000473:pathology / Q000628:therapy*; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006412:Hematopoietic Stem Cells / Q000473:pathology*; D006801:Humans; D008231:Lymphopenia / Q000209:etiology; D008297:Male; D008875:Middle Aged