Ideal or actual body weight to calculate CD34+ cell doses for autologous hematopoietic stem cell transplantation?
The number of CD34+ cells infused influences the speed of hematologic recovery post-transplant. There are limited data on whether ideal (IBW) or actual (ABW) body weight should be used to calculate CD34+ cell dose. We compared the correlation between recovery to 0.5 x 10(9)/l neutrophils and the CD34+ cell dose based upon ABW as well as IBW in 87 patients autografted for cancer. ABW was >or=25% over IBW in 43% of patients. The median number of CD34+ cells administered was 3.6 x 10(6)/kg ABW and 4.2 x 10(6)/kg IBW. The time to neutrophil recovery was 8-15 days (median 10). There was a stronger inverse correlation between CD34+ cell dose/IBW and neutrophil recovery (r(2)=0.308; P<0.0001) than between CD34+ cell dose/ABW and neutrophil recovery (r(2)=0.267; P<0.0001). The median time to neutrophil recovery was comparable for those receiving >or=2 x 10(6)/kg CD34+ cells/kg IBW as well as ABW (10 days) and those receiving >or=2 x 10(6)/kg CD34+ cells/kg IBW but <2/kg ABW (10 days), but was significantly slower for those receiving <2 x 10(6)/kg CD34+ cells/kg IBW (12 days). These data show that the CD34+ cell dose based on IBW is a better predictor of neutrophil recovery after autotransplantation.
Ali
M Y
MY
Hematopoietic Stem Cell Transplant Program, Division of Hematology/Oncology, The Feinberg School of Medicine, Northwestern University, The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.
Oyama
Y
Y
Monreal
J
J
Winter
J N
JN
Tallman
M S
MS
Williams
S F
SF
Singhal
S
S
Gordon
L I
LI
Mehta
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D018952:Antigens, CD34 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000276:immunology / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D013997:Time Factors; D014182:Transplantation, Autologous / Q000276:immunology*; D016896:Treatment Outcome
D015703:Antigens, CD; D018952:Antigens, CD34; D015415:Biomarkers