title: Allogeneic peripheral blood progenitor cell transplantation: analysis of short-term engraftment and acute GVHD incidence in 33 cases. allo-PBPCT Spanish Group.
abstract: 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%).
authors.affiliation: Hospital Clinic, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Urbano-Ispizua
authors.forename: C
authors.initials: C
authors.lastname: Solano
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.forename: F
authors.initials: F
authors.lastname: Hernández
authors.forename: G
authors.initials: G
authors.lastname: Sanz
authors.forename: A
authors.initials: A
authors.lastname: Alegre
authors.forename: J
authors.initials: J
authors.lastname: Petit
authors.forename: J
authors.initials: J
authors.lastname: Besalduch
authors.forename: P
authors.initials: P
authors.lastname: Vivancos
authors.forename: M A
authors.initials: MA
authors.lastname: Díaz
authors.forename: J M
authors.initials: JM
authors.lastname: Moraleda
authors.forename: E
authors.initials: E
authors.lastname: Carreras
authors.forename: E
authors.initials: E
authors.lastname: Ojeda
authors.forename: J
authors.initials: J
authors.lastname: de la Rubia
authors.forename: I
authors.initials: I
authors.lastname: Benet
authors.forename: A
authors.initials: A
authors.lastname: Domingo-Albós
authors.forename: J
authors.initials: J
authors.lastname: García-Conde
authors.forename: C
authors.initials: C
authors.lastname: Rozman
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim; D016572:Cyclosporine; D000069585:Filgrastim; D008727:Methotrexate