Specific Factors Influence the Success of Autologous and Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Successful hematopoietic stem cell transplantation (HSCT), both autologous and allogeneic, requires a rapid and durable engraftment, with neutrophil (>500/µL) and platelet (>20,000/µL) reconstitution. Factors influencing engraftment after autologous or allogeneic HSCT were investigated in 65 patients: 25 autologous peripheral stem cell transplantation (PBSCT) and 40 allogeneic bone marrow transplantation (BMT) patients. The major factor affecting engraftment was the graft source for HSCT. Neutrophil and platelet recovery were more rapid in autologous PBSCT than in allogeneic BMT [neutrophil occurring in median on day 10.00 (09.00/11.00) and 19.00 (16.00/23.00) and platelet on day 11.00 (10.00/13.00) and 21.00 (18.00/25.00), respectively; p < 0.0001]. The type of disease also affected engraftment, where multiple myeloma (MM) and lymphoma showed faster engraftment when compared with leukemia, syndrome myelodysplastic (SMD) and aplastic anemia (AA) and MM presented the best overall survival (OS) in a period of 12 months. Other factors included the drug used in the conditioning regimen (CR), where CBV, melphalan (M-200) and FluCy showed faster engraftment and M-200 presented the best OS, in a period of 12 months and age, where 50–59 years demonstrated faster engraftment. Sex did not influence neutrophil and platelet recovery.

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

“…Age 50–59 years demonstrated faster engraftment. Sex did not influence neutrophil and platelet recovery in this study [7]. Quite the opposite, sex had a significant influence on the neutrophil engraftment in autologous transplanted patients with AML and lymphoma in our study, and on platelet engraftment in autologous transplanted patients with lymphoma.…”

“…This therapy consists of the intravenous infusion of hematopoietic progenitor cells to reestablish marrow function in patients with damaged or defective bone marrow [7]. Transplantation of hematopoietic stem cells (HSC) provides complete and long-term reconstitution of the hematopoietic system of the patients [8, 9] and may result in remission or cure in a proportion of cases [1].…”

Endothelial Cells Promote Expansion of Long-Term Engrafting Marrow Hematopoietic Stem and Progenitor Cells in Primates

“…The third animal achieved neutrophil engraftment on day 21; this delayed reconstitution, blood transfusion requirements, and failure to recover platelet counts were attributed to latent malarial infection. For animals A11224 and Z13018, platelet recovery (>20,000 cells per microliter) without transfusion occurred after neutrophil recovery, consistent with the kinetics of recovery observed after clinical mobilized peripheral blood HSPCT (range, 16–20 days) []. These data show that ECs do not cause infusional toxicity and do not persist and indicate that EC‐expanded CD34 + cells exhibit similar engraftment kinetics to patients undergoing HSPCT.…”

Insulin-like growth factor 2 modulates murine hematopoietic stem cell maintenance through upregulation of p57

“…Growth factors such as SCF, Flt-3 ligand, IL-3, IL-6, G-CSF (granulocyte colony-stimulating factor), and TPO are the most common cytokines used for expansion of human CD34+ cells 49–51 . Several of these have been shown to have direct effects on HSC self-renewal and quiescence.…”