Prediction of engraftment after autologous peripheral blood progenitor cell transplantation: CD34, colony-forming unit-granulocyte-macrophage, or both?
BACKGROUND
The rate of hematologic recovery after peripheral blood progenitor cell (PBPC) transplantation is influenced by the dose of progenitor cells. Enumeration of cells that express CD34+ on their surface is the most frequently used method to determine progenitor cell dose. In vitro growth of myeloid progenitor cells (colony-forming unit-granulocyte-macrophage [CFU-GM]) requires more time and resources, but may add predictive information.


METHODS
A series of 323 patients, who underwent autologous PBPC transplantation for multiple myeloma, malignant lymphoma, or locally advanced breast cancer, were studied for the effect of CD34+ dose and CFU-GM dose on hematologic recovery. Measures for engraftment were days to absolute granulocyte and platelet (PLT) counts to greater than 500 per muL and than 20 x 10(9) per L, respectively, and number of PLT transfusions and red cell units required.


RESULTS
The CD34+ dose had a median of 8.4 x 10(6) per kg, and the CFU-GM dose a median of 84.9 x 10(4) per kg. The CD34+ and CFU-GM doses showed significant correlation (R = 0.63; p < 0.0001) but a wide variation in the ratio of CD34+ and CFU-GM. Both CD34+ and CFU-GM doses had significant correlation with the measures of engraftment, but for all measures the relationship of CD34+ was stronger. Multivariate analysis and subgroup analysis of patients receiving CD34+ doses of less than 5 x 10(6) per kg also did not reveal an independent predictive value for CFU-GM.


CONCLUSIONS
For prediction of hematologic recovery after autologous PBPC transplantation, determination of CFU-GM dose does not add to the predictive value of the CD34+ dose.
Jansen
Eva M
EM
Indiana Blood and Marrow Transplantation, Beech Grove, Indiana, USA.
Hanks
Susan G
SG
Terry
Colin
C
Akard
Luke P
LP
Thompson
James M
JM
Dugan
Michael J
MJ
Jansen
Jan
J
D018952:Antigens, CD34 / Q000378:metabolism*; D002478:Cells, Cultured; D003114:Colony-Forming Units Assay; D006098:Granulocytes / Q000166:cytology* / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008223:Lymphoma / Q000097:blood; D008264:Macrophages / Q000166:cytology* / Q000378:metabolism; D009101:Multiple Myeloma / Q000097:blood; D015999:Multivariate Analysis; D023461:Myeloid Progenitor Cells / Q000166:cytology / Q000378:metabolism; D009369:Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery; D036102:Peripheral Blood Stem Cell Transplantation; D011237:Predictive Value of Tests; D011379:Prognosis; D013234:Stem Cells; D014182:Transplantation, Autologous
D018952:Antigens, CD34