title: Predictive factors for rapid neutrophil and platelet engraftment after allogenic peripheral blood stem cell transplantation in patients with acute leukemia.
abstract: The aim of this study was to investigate predictive factors for rapid engraftment after allogeneic peripheral blood stem cell transplantation (alloPBSCT) in patients with acute leukemia. Two hundred sixty-two patients receiving alloPBSCT were analyzed. Subset analyses of donor stem cells were conducted using a flow cytometric method. The correlation between rapid engraftment of neutrophils, platelets, and donor stem cells doses, as well as other recipient and donor clinical factors, was analyzed. In univariate analysis, factors correlated with neutrophil engraftment (≥0.5 × 10(9)/L) by day 12 were achievement of complete remission (CR) after induction chemotherapy (CR1) before hematopoietic cell transplantation (HCT) and high numbers of CD34+ cells, CD3+ T cells, and CD3+/CD4+ T cells. Factors correlated with platelet engraftment (≥20 × 10(9)/L) by day 12 were achievement of CR1 before HCT, donor and recipient sex mismatch, and high numbers of mononuclear cells, CD34+ cells, CD3+ T cells, CD3+/CD4+ T cells, CD3+/CD8+ T cells, and CD56+ NK cells. In multivariate analysis, independent predictive factors for rapid neutrophil and platelet engraftment were CR1 before HCT (p < 0.001 and p = 0.002, respectively), high number of donor CD34+ cells (p = 0.005 and p < 0.001, respectively), and high number of CD3+ T cells (p = 0.005 and p = 0.001, respectively). In conclusion, achieving CR1 before HCT, as well as larger quantities of donor CD34+ and CD3+ T cells, may predict rapid neutrophil and platelet engraftment after PBSCT.
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
authors.forename: Ho Sup
authors.initials: HS
authors.lastname: Lee
authors.forename: Lee Chun
authors.initials: LC
authors.lastname: Park
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Lee
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Shin
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Joon-Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Mi Hyang
authors.initials: MH
authors.lastname: Kim
authors.forename: Byeong Jin
authors.initials: BJ
authors.lastname: Ye
authors.forename: Joo-Seop
authors.initials: JS
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000637:transplantation*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D017713:Platelet Transfusion / Q000379:methods*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000601:surgery*; D011237:Predictive Value of Tests; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods; D055815:Young Adult