title: Factors influencing engraftment in HLA-haploidentical/mismatch related transplantation with combined granulocyte-colony stimulating factor-mobilized peripheral blood and bone marrow for patients with leukemia.
abstract: Unmanipulated HLA-haploidentical/mismatch related transplantation with combined granulocyte-colony stimulating factor-mobilized peripheral blood stem cells (G-PBSCs) and granulocyte-colony stimulating factor-mobilized bone marrow (G-BM) has been used as an alternative transplantation strategy for patients without an HLA-matched donor. In this transplantation setting, factors associated with hematopoietic recovery have not been defined completely. The aim of this study was to investigate the factors influencing the engraftment in this transplantation setting for patients with leukemia. The study group comprised 104 patients with leukemia who underwent transplantation at a single institution between 2005 and 2008. Factors correlating with neutrophil and platelet engraftment post-transplantation were analyzed retrospectively. All patients achieved an absolute neutrophil count of 500/μL with a mean time of 13.6days (range 8-20days) and a platelet count over 20×10(9)/L with a mean time of 20.2days (range 16-26days). In univariate analysis, donor and age were associated with increased risk of neutrophil engraftment, but their significance was lost upon multivariate analysis. The sex, age, donor, CD34(+) cell dose, conditioning regimen, mismatched locus, ABO mismatched and diagnosis have no effect on platelet engraftment. Our results suggest that it is an ideal approach to treat patients with leukemia with HLA-haploidentical/mismatched related transplantation with combined G-PBSCs and G-BM for a high level of stem cells without delayed engraftment.
authors.affiliation: Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.forename: Xing-Hua
authors.initials: XH
authors.lastname: Chen
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.forename: Pei-Yan
authors.initials: PY
authors.lastname: Kong
authors.forename: Xian-Gui
authors.initials: XG
authors.lastname: Peng
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Sun
authors.forename: Qing-Yu
authors.initials: QY
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006680:HLA Antigens; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000378:metabolism / Q000628:therapy*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous
chemical_list: D006680:HLA Antigens; D016179:Granulocyte Colony-Stimulating Factor