Analysis of Factors that Influence Hematopoietic Recovery in Autologous Transplanted Patients with Hematopoietic Stem Cells from Peripheral Blood

Grubovic, Rada; Georgievski, Borce; Čevreska, Lidija; Genadieva-Stavric, Sonja; Grubovic, M.

doi:10.3889/oamjms.2017.039

Cited by 20 publications

(16 citation statements)

References 25 publications

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“…Tricot et al, 8 showed that only patients with MM ≤ 50 years old showed only significant for faster platelet engraftment in MM patients. Grubovic et al, 29 concluded that age was one of the potentially important variables for both neutrophil and platelet engraftment among lymphoma patients and Goncalves et al, 2 showed that patients with hematological malignancies aged 50–59 years demonstrated significant faster engraftment.…”

Section: Discussionmentioning

confidence: 99%

Autologous Peripheral Blood Stem Cell Transplantation Among Lymphoproliferative Disease Patients: Factors Influencing Engraftment

Hassan¹,

Fauzi²,

Husin³

et al. 2019

Oman Med J

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ObjectivesAutologous peripheral blood stem cells transplantation (APBSCT) is a therapeutic option which can be used in various hematological, neoplastic disorders including lymphoproliferative disease (LPD). Differences in patient populations and treatment modalities in different transplant centers mean it is important to improve the knowledge of the different factors affecting engraftment after APBSCT for the success of this procedure. We sought to determine the factors influencing neutrophil and platelet engraftment after APBSCT in patients with LPD.MethodsWe conducted a retrospective review of 70 patients with LPD (35 with lymphoma and 35 with multiple myeloma) who had undergone APBSCT between January 2008 and December 2016. Data obtained included disease type, treatment, and stem cell characteristics. Kaplan-Meier analysis was performed for probabilities of neutrophil and platelet engraftment occurred and was compared by the log-rank test. The multivariate Cox proportional hazards regression model was used for the analysis of potential independent factors influencing engraftment. A p-value < 0.050 was considered statistically significant.ResultsMost patients were ethnic Malay, the median age at transplantation was 49.5 years. Neutrophil and platelet engraftment occurred in a median time of 18 (range 4–65) and 17 (range 6–66) days, respectively. The majority of patients showed engraftment with 65 (92.9%) and 63 (90.0%) showing neutrophil and platelet engraftment, respectively. We observed significant differences between neutrophil engraftment and patient’s weight (< 60/≥ 60 kg), stage of disease at diagnosis, number of previous chemotherapy cycles (< 8/≥ 8), and pre-transplant radiotherapy. While for platelet engraftment, we found significant differences with gender, patient’s weight (< 60/≥ 60 kg), pre-transplant radiotherapy, and CD34+ dosage (< 5.0/≥ 5.0 × 106/kg and < 7.0/≥ 7.0 × 106/kg). The stage of disease at diagnosis (p = 0.012) and pre-transplant radiotherapy (p = 0.025) were found to be independent factors for neutrophil engraftment whereas patient’s weight (< 60/≥ 60 kg, p = 0.017), age at transplantation (< 50/≥ 50 years, p = 0.038), and CD34+ dosage (< 7.0/≥ 7.0 × 106/kg, p = 0.002) were found to be independent factors for platelet engraftment.ConclusionsPatients with LPD who presented at an early stage and with no history of radiotherapy had faster neutrophil engraftment after APBSCT, while a younger age at transplantation with a higher dose of CD34+ cells may predict faster platelet engraftment. However, additional studies are necessary for better understanding of engraftment kinetics to improve the success of APBSCT.

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Section: Discussionmentioning

confidence: 99%

Autologous Peripheral Blood Stem Cell Transplantation Among Lymphoproliferative Disease Patients: Factors Influencing Engraftment

Hassan¹,

Fauzi²,

Husin³

et al. 2019

Oman Med J

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“…Although this factor has the potential to confound results, previously reported data does not support a meaningful difference in time to engraftment based on sex. 13 , 14 Therefore, median time to neutrophil engraftment in this study was unlikely to be affected by the observed difference in patient sex.…”

Section: Discussionmentioning

confidence: 79%

Flat-dose granulocyte colony-stimulating factor evaluation after autologous hematopoietic stem cell transplant in multiple myeloma patients: Does one dose fit all?

Kim

Jared

Hennes

et al. 2020

J Oncol Pharm Pract

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Introduction The current recommended granulocyte-colony stimulating factor (G-CSF) dose after autologous hematopoietic stem cell transplant (autoHSCT) in multiple myeloma patients is 5 mcg/kg/day administered subcutaneously until engraftment. Recently, our institution changed practice from weight-based to flat-dose G-CSF. The purpose of this study was to assess the impact of flat-dose G-CSF on time to engraftment among multiple myeloma patients of different weight groups. Methods Retrospective chart review was completed for adult patients with multiple myeloma who underwent autoHSCT from March 2018 through August 2019. Data collected included time to neutrophil engraftment, total length of hospitalization, length of stay post-transplant, time to platelet engraftment, use of intravenous fluconazole or acyclovir, parenteral nutrition use, incidence of febrile neutropenia, antibiotic use, and death. Differences in outcomes were compared between patients ≤80 kg versus those >80 kg. A secondary analysis was completed for patients ≤100 kg versus those >100 kg. Results There was no difference in time to neutrophil engraftment between weight groups (≤80 kg versus >80 kg: median = 12 days, p = 0.22; ≤100 kg versus >100 kg: median = 12 days, p = 0.52). There was a significant difference in intravenous fluconazole and acyclovir use between groups, with more use in the lower weight groups (≤80 kg versus >80 kg: 12 patients versus 10 patients p = 0.02; ≤100 kg versus >100 kg: 19 patients versus 3 patients p = 0.04). No significant differences were found for any other outcomes. Conclusion Utilizing a flat-dose of G-CSF for patients after autoHSCT does not appear to negatively affect patient outcomes. Institutions may benefit from using the 300 mcg dose of G-CSF for multiple myeloma patients after autoHSCT.

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“…In a separate study, higher yields of CD34 + cells (7 £ 10 6 /kg) were associated with an inferior prognosis owing to a significantly higher RR [65]. Grubovic et al [66] demonstrated that neutrophil engraftment is correlated with the number of transplanted CD34 + cells and mononuclear cells, but not with platelet engraftment. Therefore, clinical outcomes after ASCT in patients with AML are significantly affected by CD34 + cell counts.…”

Section: Cd34 + Cell Count and Other Factors Influencing Hematologic mentioning

confidence: 94%

Autologous Hematopoietic Stem Cell Transplantation in Acute Myelogenous Leukemia

Zhao

Chen

Feng

2019

Biology of Blood and Marrow Transplantation

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The clinical outcomes of autologous hematopoietic stem cell transplantation (ASCT) in acute myelogenous leukemia (AML) have improved over time. Indeed, numerous studies have demonstrated that ASCT is associated with a lower relapse rate and acceptable nonrelapse mortality compared with chemotherapy alone in patients with AML. In addition, ASCT is also associated with comparable overall survival outcomes to those of allogeneic hematopoietic stem cell transplantation in some patients with AML. To date, age, cytogenetic and molecular risk stratification, and minimal residual disease (MRD) status have been shown to be closely related to clinical outcomes following ASCT. ASCT is recommended for patients with favorable-risk and intermediate-risk AML in first complete remission and patients with acute promyelocytic leukemia in second complete remission for whom a matched sibling donor is not available. MRD status pre-ASCT is the most important factor to consider when determining whether a patient is eligible for ASCT and can effectively predict clinical outcomes after ASCT. Advanced age is not an absolute contradiction for ASCT. In this review, we describe the literature and clinical trials evaluating the outcomes of ASCT in patients with AML and discuss the indications for ASCT therapy. Because the greatest concern in ASCT recipients is early relapse, important factors that should be monitored before ASCT and future perspectives in this area are also presented.

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Analysis of Factors that Influence Hematopoietic Recovery in Autologous Transplanted Patients with Hematopoietic Stem Cells from Peripheral Blood

Cited by 20 publications

References 25 publications

Autologous Peripheral Blood Stem Cell Transplantation Among Lymphoproliferative Disease Patients: Factors Influencing Engraftment

Autologous Peripheral Blood Stem Cell Transplantation Among Lymphoproliferative Disease Patients: Factors Influencing Engraftment

Flat-dose granulocyte colony-stimulating factor evaluation after autologous hematopoietic stem cell transplant in multiple myeloma patients: Does one dose fit all?

Autologous Hematopoietic Stem Cell Transplantation in Acute Myelogenous Leukemia

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