Actual or ideal body weight to calculate CD34+ cell dose in patients undergoing autologous hematopoietic SCT for myeloma?
CD34+ cell dose calculations are usually based on actual body weight (ABW). We have shown that ideal body weight (IBW) may provide a better basis for this in a small population of patients with hematologic malignancies. This was studied further in 514 myeloma autografts. The CD34+ cell doses (10(6)/kg) by IBW and ABW were 1.37-39.36 (median 6.03) and 1.15-29.67 (median 4.84), respectively. IBW-based cell doses correlated slightly better with engraftment than ABW-based doses (higher r(2)): 0.5 x 10(9)/l neutrophils 0.83 versus 0.82, 1.0 x 10(9)/l neutrophils 0.78 versus 0.77, 20 x 10(9)/l platelets 0.54 versus 0.53 and 50 x 10(9)/l platelets 0.57 versus 0.55. When outliers (hematologic recovery in <8 or >16 days) were excluded, the findings were similar: 0.5 x 10(9)/l neutrophils 0.85 versus 0.84, 1.0 x 10(9)/l neutrophils 0.85 versus 0.84, 20 x 10(9)/l platelets 0.86 versus 0.85 and 50 x 10(9)/l platelets 0.85 versus 0.84. CD34+ cell doses based on IBW as well as ABW significantly affected engraftment when analyzed separately as continuous variables. However, when analyzed together, only the dose based on IBW retained significance. We conclude that calculation of CD34+ cell numbers for autotransplantation should be based on IBW.
Department of Hematology/Oncology, Northwestern University Medical School, 676 North St Clair Street, Chicago, IL 60611, USA.
V
V
Singh
J
J
Krishnamurthy
S
S
Duffey
R
R
Meagher
M
M
Villa
J
J
Monreal
A
A
Evens
O
O
Frankfurt
J
J
Altman
L
L
Gordon
M
M
Tallman
S
S
Williams
J
J
Winter
S
S
Singhal
J
J
Mehta
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D001835:Body Weight; D003131:Combined Modality Therapy; D005260:Female; D019337:Hematologic Neoplasms / Q000097:blood / Q000628:therapy*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000628:therapy*; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods
D018952:Antigens, CD34; D015415:Biomarkers; D008558:Melphalan