Prediction of engraftment after autologous peripheral blood progenitor cell transplantation: CD34, colony‐forming unit–granulocyte‐macrophage, or both?

Abstract

For prediction of hematologic recovery after autologous PBPC transplantation, determination of CFU-GM dose does not add to the predictive value of the CD34+ dose.

Consolidation with autologous stem cell transplantation in first remission is safe and effective in AML patients above 65 years

“…However, differing outcome rates in various risk groups were observed in our somewhat larger group of younger patients undergoing ASCT (n=49) suggesting that the benefit of ASCT consolidation is limited to favorable risk groups of AML. Compared to chemotherapy consolidation, ASCT provides timely hematologic recovery, thereby reducing the probability of infectious or hemorrhagic complications [8,9]. Reduced intensity conditioning (RIC) with allogeneic stem cell transplantation has also been investigated as a consolidation strategy in elderly AML patients.…”

Slow platelet recovery after PBPC transplantation from unrelated donors

“…7,8 Although the minimum dose of PBPCs for autologous recovery, expressed as dose of CD34 þ cells, is as low as 1-2 Â 10 6 /kg, 9 doses of at least 5 Â 10 6 /kg have been shown to result in faster recovery of, in particular, the platelet count. 7,8 Indeed, highly significant correlations exist between the CD34 þ cell dose and the number of days until absolute granulocyte count (AGC) 4500/mm 3 and days until unsupported platelet count 420 000/mm 3 , respectively. [6][7][8][9] As many patients receiving relatively small doses of CD34 þ cells show adequate engraftment, the importance of the composition of the PBPC allograft has received only limited attention.…”

“…5 The composition of the stem cell graft has a major influence on the engraftment kinetics after autologous PBPC transplantation. [6][7][8] Thus, increasing the dose of PBPCs results in faster hematologic recovery with lower resource utilization. 7,8 Although the minimum dose of PBPCs for autologous recovery, expressed as dose of CD34 þ cells, is as low as 1-2 Â 10 6 /kg, 9 doses of at least 5 Â 10 6 /kg have been shown to result in faster recovery of, in particular, the platelet count.…”

“…7,8 Indeed, highly significant correlations exist between the CD34 þ cell dose and the number of days until absolute granulocyte count (AGC) 4500/mm 3 and days until unsupported platelet count 420 000/mm 3 , respectively. [6][7][8][9] As many patients receiving relatively small doses of CD34 þ cells show adequate engraftment, the importance of the composition of the PBPC allograft has received only limited attention. [10][11][12][13] The effect of the composition of the PBPC grafts from MRDs and from MUDs on hematologic recovery of the patents was studied, with particular attention to the differences between MRD and MUD grafts.…”

“…[6][7][8] Thus, increasing the dose of PBPCs results in faster hematologic recovery with lower resource utilization. 7,8 Although the minimum dose of PBPCs for autologous recovery, expressed as dose of CD34 þ cells, is as low as 1-2 Â 10 6 /kg, 9 doses of at least 5 Â 10 6 /kg have been shown to result in faster recovery of, in particular, the platelet count. 7,8 Indeed, highly significant correlations exist between the CD34 þ cell dose and the number of days until absolute granulocyte count (AGC) 4500/mm 3 and days until unsupported platelet count 420 000/mm 3 , respectively.…”