Predictive factors for long-term engraftment of autologous blood stem cells.
Data from 170 consecutive patients aged 19-66 years (median age 46 years) who underwent unmanipulated autologous blood stem cell transplant (ASCT) were analyzed to determine if total CD34+ cells/kg infused, CD34+ subsets (CD34+41+, CD34+90+, CD34+33-, CD34+38-, CD34+38-DR-), peripheral blood CD34+ cell (PBCD34+) count on first apheresis day, or various clinical factors were associated with low blood counts 6 months post ASCT. Thirty-four patients were excluded from analysis either because of death (n = 17) or re-induction chemotherapy prior to 6 months post ASCT (n = 13), or because of lack of follow-up data (n = 4). Of the remaining 136 patients, 46% had low WBC ( < 4 x 10(9)/l), 41% low platelets (<150 x 10(9)/l), and 34% low hemoglobin ( < 120 g/l) at a median of 6 months following ASCT. By Spearman's rank correlation, both the total CD34+ cell dose/kg and the PBCD34+ count correlated with 6 month blood counts better than any subset of CD34+ cells or any clinical factor. The PBCD34+ count was overall a stronger predictor of 6 month blood counts than was the total CD34+ cells/kg infused. Both factors retained their significance in multivariate analysis, controlling for clinical factors. In conclusion, subsets of CD34+ cells and clinical factors are inferior to the total CD34+ cell dose/kg and PBCD34+ count in predicting 6 month blood counts following ASCT.
Department of Medicine, Tom Baker Cancer Center, Foothills Hospital, and University of Calgary, Calgary, Alberta, Canada.
P R
PR
Duggan
D
D
Guo
J
J
Luider
I
I
Auer
J
J
Klassen
A
A
Chaudhry
D
D
Morris
S
S
Glück
C B
CB
Brown
J A
JA
Russell
D A
DA
Stewart
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D001772:Blood Cell Count; D001804:Blood Transfusion, Autologous / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000592:standards; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014182:Transplantation, Autologous / Q000592:standards*
D018952:Antigens, CD34