Early identification of patients at risk of death due to infections, hemorrhage, or graft failure after allogeneic bone marrow transplantation on the basis of the leukocyte counts

Mehta, Jayesh; Powles, R; Singhal, Seema; Horton, C; Middleton, Gary; Eisen, Timothy; Meller, S; Pinkerton, CR; Treleaven, J

doi:10.1038/sj.bmt.1700657

Cited by 34 publications

(18 citation statements)

References 2 publications

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“…Because of the significant effect TNC dose has on the outcome of allogeneic transplantation, [15][16][17] we aimed to collect 3 ϫ 10 8 TNC/kg from BM. CD34 ϩ cell measurement is likely to be a more precise measure of cell dose.…”

Section: Discussionmentioning

confidence: 99%

Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation

Singhal

Powles

Kulkarni

et al. 2000

Bone Marrow Transplant

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Summary:Forty healthy adult donors underwent marrow (BM) as well as peripheral blood (PBSC) stem cell collections for their HLA-identical adult siblings with hematologic malignancies. BM was harvested on day 1 (target 3 ؋ 10 8 nucleated cells/kg, 10 g/kg lenograstim (glycosylated G-CSF) administered on days 2-6, and a single leukapheresis performed on day 6. The blood volume processed was the higher of 200% donor blood volume or 10 liters. The total nucleated cell (TNC) yields from PBSC were 1.1-to 4.3-fold higher than BM (median 7.0 vs 3.1 ؋ 10 8 /kg, P Ͻ 0.0001). Although BM contained a higher proportion of CD34 + cells (1.3% vs 0.7%, P Ͻ 0.0001) and a comparable proportion of CD3 + cells (median 29% vs 26%, P = 0.4), the absolute numbers of CD34 + and CD3 + cells and their subsets were several times higher in PBSC. There was a poor correlation between BM and PBSC CD34 and TNC numbers, but a significant correlation between BM and PBSC CD3 numbers. Only five of 40 BM harvests contained у2 ؋ 10 6 CD34 + cells/kg compared with 35 of 40 PBSC harvests (P Ͻ 0.0001). We conclude that the numbers of progenitor and immunocompetent cells in PBSC are several times higher than in BM. It is possible to collect adequate numbers of progenitor cells from blood after lenograstim stimulation more frequently than from marrow, and donors yielding low quantities of progenitor cells from BM usually deliver better quantities from PBSC. Bone Marrow Transplantation (2000) 25, 501-505.

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Section: Discussionmentioning

confidence: 99%

Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation

Singhal

Powles

Kulkarni

et al. 2000

Bone Marrow Transplant

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“…Early treatment with growth factors (G-CSF or GM-CSF) between days 14 and 16 post BMT, when absolute neutrophil counts are Ͻ0.2 × 10 9 /l, must be considered. 14 If no response is observed after 5 to 7 days, a further infusion of G-CSF mobilized peripheral blood stem cells, with or without a new conditioning regimen, should be undertaken. 15,16 …”

Section: Bone Marrow Transplantationmentioning

confidence: 99%

Second bone marrow transplantation for severe aplastic anemia: analysis of 34 cases

Medeiros

Bitencourt

Medeiros

et al. 2001

Bone Marrow Transplant

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Summary:Severe aplastic anemia (sAA) is a bone marrow failure disorder which is mostly a consequence of immunologically mediated stem cell destruction. Allogeneic bone marrow transplantation (BMT) from a compatible donor provides long-term survival in 60 to 80% of sAA patients. However, graft rejection still remains a major problem, and a second allograft is an alternative for these patients. We retrospectively analyzed 34 patients who received a second BMT (BMT2), nine with primary graft failure (PGF) and 25 with transient engraftment (TE). The probability of survival at 13 years among PGF patients was 22% vs 60% for the TE group (P = 0.0068). Age (Ͻ17 vs Ͼ17 years), number of mononuclear cells (Ͻ3 vs Ͼ3 × 10 8 /kg) and year of transplant (1986-1991 vs 1992-1998) at BMT2 had no statistical influence on survival. A significant survival advantage was noted among TE patients (P = 0.0068), which was probably because of a longer intertransplant interval (Ͼ90 days). Furthermore, 90% of patients with positive blood cultures at BMT2 did not survive the procedure. We conclude that early detection of primary graft failure (PGF), followed by measures attempting to promote hematopoietic recovery (eg use of growth factors, further infusion of stem cells) may decrease mortality. Bone Marrow Transplantation (2001) 28, 941-944.

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“…Bone Marrow Transplantation (2005) 36, 227-232. doi:10.1038/sj.bmt.1705025; published online 6 June 2005 Keywords: oral rinse; neutrophil; hematopoietic stem cell transplantation Myeloid engraftment following hematopoietic stem cell transplantation (HSCT) has conventionally been defined as the first of three consecutive days the patient presents an absolute neutrophil count (ANC) of 0.5 Â 10 9 /l or more. [1][2][3][4] Although it would be ideal to be able to monitor routinely the return of white blood cells to tissues following HSCT, there are currently no noninvasive methods available to assess accurately this important end point. Blood counts are obtained routinely from HSCT patients treated with intense myelosuppressive conditioning regimens to monitor engraftment and the onset and resolution of neutropenia.…”

mentioning

confidence: 99%

A noninvasive oral rinse assay to monitor engraftment, neutrophil tissue delivery and susceptibility to infection following HSCT in pediatric patients

Cheretakis

Dror

Glogauer

2005

Bone Marrow Transplant

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Early identification of patients at risk of death due to infections, hemorrhage, or graft failure after allogeneic bone marrow transplantation on the basis of the leukocyte counts

Cited by 34 publications

References 2 publications

Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation

Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation

Second bone marrow transplantation for severe aplastic anemia: analysis of 34 cases

A noninvasive oral rinse assay to monitor engraftment, neutrophil tissue delivery and susceptibility to infection following HSCT in pediatric patients

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