Early neutrophil engraftment following autologous BMT provides a functional predictor of long-term hematopoietic reconstitution.
BACKGROUND
Previous studies have demonstrated that the number of CD34+ progenitor cells in the stem cell graft is highly predictive of the rapidity of short-term hematopoietic engraftment. The aim of this study was to identify factors that predict long-term hematopoietic reconstitution (LHR) following autologous BMT.


METHODS
To identify predictors of LHR, peripheral blood counts and marrow biopsies were evaluated at 1 year after transplant in 81 patients with B-cell non-Hodgkin's lymphoma (NHL) or chronic lymphocytic leukemia who underwent autologous BMT. Results were correlated with CD34+ cell dose, granulocyte-monocyte colony-forming units (CFU-GM) infused, and time to neutrophil engraftment (TNE).


RESULTS
Total MNC dose, CD34+ cell dose, and CFU-GM infused were significantly associated with TNE (p = 0.011, p < 0.0001, and p = 0.078, respectively). Patients with chronic lymphocytic leukemia were more likely to have received a low CD34+ cell dose than patients with B-cell non-Hodgkin's lymphoma (p = 0.01). Among the four principal predictors, only TNE showed consistent significant correlation with WBC, absolute neutrophil, and platelet count at 1 year after transplant. Logistic regression model showed that TNE was a more sensitive predictor of LHR than either CD34+ cell dose or CFU-GM infused.


CONCLUSIONS
TNE is an in vivo functional measure of LHR and is a more sensitive predictor of LHR at 1 year after BMT than either CD34+ cell dose or CFU-GM infused.
Zubair
Abba
A
Connell O'Reilly Cell Manipulation Core Facility and the Department of Adult Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115, USA.
Zahrieh
David
D
Daley
Heather
H
Schott
Daryls
D
Gribben
John G
JG
Freedman
Arnold
A
Ritz
Jerome
J
D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D001854:Bone Marrow Cells / Q000473:pathology*; D016026:Bone Marrow Transplantation; D002455:Cell Division; D005260:Female; D005544:Forecasting; D006412:Hematopoietic Stem Cells / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011184:Postoperative Period; D012044:Regression Analysis; D013997:Time Factors
D018952:Antigens, CD34