title: Factors affecting hematopoietic recovery after autologous peripheral blood progenitor-cell transplantation in aggressive non-Hodgkin's lymphoma: a prospective study of 123 patients.
abstract: OBJECTIVE
  To analyse prognostic factors influencing hematopoietic recovery in patients with aggressive non-Hodgkin's lymphomas prospectively treated with intensive chemotherapy followed by peripheral blood progenitor-cells transplantation.
  
  
  METHODS
  Untreated patients with at least two unfavorable factors according to the age-adjusted international prognostic index were included in the LNH 93-3 trial. Patients received three cycles of chemotherapy and PBPC were mobilized using filgrastim. On day 60, a BEAM regimen was initiated followed by PBPC rescue. Among the 123 patients analysed, 60 received G-CSF (5 microg/kg/d) after PBPC transplantation at day 1 and 63 did not.
  
  
  RESULTS
  Patients received a mean number of 12.4 x 10(6)/kg (1.86-111.5) CD34+ cells. After transplantation, neutrophil counts exceeded 0.5 x 10(9)/l at a median of 12.4 days (7-41 days) and platelet counts exceeded 50 x 10(9)/l at a median of 15.6 days (9-141 days). Platelets recovery > 50 x 10(9)/l was negatively influenced by BM involvement (20 s 14 days; P = 0.04). The number of CD34+ cells infused (> vs < or = 5 x 10(6)/kg) was correlated with faster platelet recovery (18.7 days vs 13.7 days) (P = 0.007). In 26 patients for whom administration of G-CSF was randomized, time to neutrophil recovery was significantly shorter for patients treated with G-CSF: 10 vs 13 days (P = 0.0005). The incidence of grade 3/4 infection, was similar in both groups.
  
  
  CONCLUSIONS
  In the patient population treated with the same first-line regimen, BM involvement and infusion of fewer CD34+ cells delayed platelet recovery. Administration of G-CSF after PBPC significantly reduced neutropenia.
authors: Service d'Hémato-Oncologie, Hopital Saint Louis AP/HP, Paris, France.
authors: A M
authors: AM
authors: Langouët
authors: P
authors: P
authors: Brice
authors: D
authors: D
authors: Simon
authors: C
authors: C
authors: Bocaccio
authors: J N
authors: JN
authors: Munck
authors: G
authors: G
authors: Fillet
authors: A M
authors: AM
authors: Peny
authors: G
authors: G
authors: Salles
authors: B
authors: B
authors: Quesnel
authors: F
authors: F
authors: Lefrere
authors: R
authors: R
authors: Felix
authors: C
authors: C
authors: Gisselbrecht
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006410:Hematopoiesis / Q000187:drug effects*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D011446:Prospective Studies; D020127:Recovery of Function / Q000187:drug effects*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor