title: Reduced hemoglobin on day of peripheral blood progenitor cell collection is associated with low graft content of vascular progenitors and increased toxicity after autologous hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Tissue damage after hematopoietic stem cell transplantation (HSCT) occurs as a result of high-dose chemotherapy and radiation. The aim was to determine the importance of pretransplant anemia on toxicity and red blood cell (RBC) transfusion requirements after autologous HSCT.
  
  
  METHODS
  A total of 350 patients undergoing autologous HSCT were included in the analysis. Patient factors and pretransplant laboratory values of possible relevance were assessed in multivariate regression analysis.
  
  
  RESULTS
  Reduced hemoglobin (Hb) on the first day of peripheral blood progenitor cell (PBPC) collection was significantly associated with increased organ toxicity after HSCT, as measured by the Seattle criteria. Lower Hb levels at baseline before transplantation, but not at PBPC collection, were significantly associated with increased RBC transfusion requirements. In a second cohort of 28 patients, higher Hb levels on the day of PBPC collection were significantly associated with increased levels of endothelial-like vascular progenitor cells in PBPC grafts.
  
  
  CONCLUSIONS
  Our observations suggest that higher Hb levels on the day of PBPC collection may be a marker of reduced toxicity associated with HSCT and increased vascular progenitors in PBPC collections. Further, baseline anemia before transplant may reflect an unfavorable hematopoietic microenvironment that leads to increased RBC transfusion requirements.
authors.affiliation: Division of Hematology, Blood and Marrow Transplant Program, The Ottawa Hospital, Ottawa Health Research Institute, Ottawa, Ontario, Canada.
authors.forename: Gurnaam
authors.initials: G
authors.lastname: Kasbia
authors.forename: Farjah
authors.initials: F
authors.lastname: Al-Gahtani
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
authors.forename: Laura
authors.initials: L
authors.lastname: Labonté
authors.forename: Alan
authors.initials: A
authors.lastname: Tinmouth
authors.forename: Timothy
authors.initials: T
authors.lastname: Ramsay
authors.forename: Akira
authors.initials: A
authors.lastname: Gillingham
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Michael
authors.initials: M
authors.lastname: Halpenny
authors.forename: Antonio
authors.initials: A
authors.lastname: Giulivi
authors.forename: Sheryl
authors.initials: S
authors.lastname: McDiarmid
authors.forename: Lothar
authors.initials: L
authors.lastname: Huebsch
authors.forename: David S
authors.initials: DS
authors.lastname: Allan
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood*; D001772:Blood Cell Count; D002452:Cell Count; D042783:Endothelial Cells / Q000637:transplantation*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014182:Transplantation, Autologous
chemical_list: D006454:Hemoglobins