title: Delayed hematopoietic recovery after auto-SCT in patients receiving arsenic trioxide-based therapy for acute promyelocytic leukemia: a multi-center analysis.
abstract: A potential link between arsenic (ATO)-based therapy and delayed hematopoietic recovery after autologous hematopoietic SCT (HSCT) for acute promyelocytic leukemia (APL) has previously been reported. We retrospectively reviewed the clinical histories of 58 patients undergoing autologous HSCT for APL at 21 institutions in the United States and Japan. Thirty-three (56%) of the patients received ATO-based therapy prior to stem cell collection. Delayed neutrophil engraftment occurred in 10 patients (17%): 9 of the 10 patients (90%) received prior ATO (representing 27% of all ATO-treated patients), compared with 1 of the 10 patients (10%) not previously treated with ATO (representing 4% of all ATO-naïve patients; P<0.001). Compared with ATO-naïve patients, ATO-treated patients experienced significantly longer times to ANC recovery (median 12 days vs 9 days, P<0.001). In multivariate analysis, the only significant independent predictor of delayed neutrophil engraftment was prior treatment with ATO (hazard ratio 4.87; P<0.001). Of the available stem cell aliquots from APL patients, the median viable post-thaw CD34+ cell recovery was significantly lower than that of cryopreserved autologous stem cell products from patients with non-APL AML. Our findings suggest that ATO exposure prior to CD34+ cell harvest has deleterious effects on hematopoietic recovery after autologous HSCT.
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: G N
authors.initials: GN
authors.lastname: Mannis
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Logan
authors.affiliation: Departments of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Leavitt
authors.affiliation: Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yanada
authors.affiliation: Department of Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Hwang
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Olin
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Damon
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Andreadis
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: W Z
authors.initials: WZ
authors.lastname: Ai
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Gaensler
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Greene
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: N K
authors.initials: NK
authors.lastname: Gupta
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Kaplan
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Mahindra
authors.affiliation: Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Hematology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Naoe
authors.affiliation: Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ohtake
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Sayre
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Smith
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Venstrom
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Wolf
authors.affiliation: Departments of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Caballero
authors.affiliation: Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Emi
authors.affiliation: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: T G
authors.initials: TG
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000008:administration & dosage / Q000009:adverse effects; D064592:Autografts; D005260:Female; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000008:administration & dosage / Q000009:adverse effects; D036102:Peripheral Blood Stem Cell Transplantation
chemical_list: D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D000077237:Arsenic Trioxide