Cytopenia and hematopoietic recovery after low intensity conditioning transplants.
OBJECTIVE
To compare hematopoietic reconstitution after low intensity conditioning transplants and standard allogeneic hematopoietic stem cell transplantation (HSCT).


METHODS
We retrospectively analyzed the kinetics of cytopenia of 50 consecutive patients treated with HSCT during a 60 day posttransplant period. Twenty four patients were treated with a low intensity regimen (Fludarabine, 2 Gy total body irradiation) and 26 patients with the standard conditioning regimen. Patients who received the low intensity HSCT were analyzed in two groups, patients with engraftment of donor hematopoiesis and those who rejected the graft.


RESULTS
Patients treated with low intensity conditioning, regardless of its outcome, experienced significantly less severe cytopenia than the patients from the control group. Except for reticulocytes, the development of cytopenia was significantly slower in these patients, and the duration of severe cytopenia was significantly shorter. However, full neutrophil recovery (absolute neutrophil count >1.0 x 10(9)/L) took longer in patients with low intensity HSCT.


CONCLUSIONS
The kinetics of cytopenia and hematopoietic recovery after low intensity conditioning HSCT significantly differ from standard HSCT. There is no difference in the initial hematopoietic recovery between patients with or without engraftment after low intensity conditioning. This indicates that the onset, severity, and duration of the cytopenia are influenced primarily by the intensity of the conditioning and by the immunosuppressive regimen after transplantation. Effects are more pronounced for neutrophils than for platelets and reticulocytes.
Clinic for Hematology, St. Cyril and Methodius University Hospital Center, Skopje, Republic of Macedonia.
Gabriela
G
Kostova
Dominik
D
Heim
Jakob
J
Passweg
Andreas
A
Buser
André
A
Tichelli
Alois
A
Gratwohl
D000328:Adult; D005260:Female; D020350:Graft vs Tumor Effect; D019337:Hematologic Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000209:etiology; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014916:Whole-Body Irradiation
D014740:Vidarabine; C024352:fludarabine