Factors that influence the collection and engraftment of allogeneic peripheral-blood stem cells in patients with hematologic malignancies.

作者：R Brown, Douglas R. Adkins, Lawrence T. Goodnough, Jeff Haug, Gordon L. Todd, M Wehde, D Hendricks, C Ehlenbeck, L.M. Laub, John F. DiPersio · 发表于：Journal of Clinical Oncology · 年份：1997 · DOI：10.1200/jco.1997.15.9.3067 · 被引用次数：74 · 研究领域：Hematopoietic Stem Cell Transplantation、Neutropenia and Cancer Infections、Acute Myeloid Leukemia Research

PURPOSE: To determine the number of CD34+ cells associated with a high probability of rapid engraftment after allogeneic peripheral-blood stem-cell (PBSC) transplant, and to examine the relationship between certain donor characteristics and the effectiveness of PBSC mobilization. PATIENTS AND METHODS: Between December 1994 and July 1996, we treated 47 patients who had resistant hematologic neoplasms with myeloablative therapy followed by transplantation of allogeneic PBSC collected from histocompatible siblings after mobilization with granulocyte colony-stimulating factor (G-CSF). Expression of CD34 was determined by flow cytometry. RESULTS: Engraftment was rapid and similar to that observed following autologous PBSC transplant, with an absolute neutrophil count (ANC) greater than 500/microL and platelet count greater than 20,000/microL on median days +9 and +11, respectively. The pace of hematologic recovery correlated with the number of hematopoietic progenitors transplanted, so that patients who received greater than 5 x 10(6) CD34+ cells/kg recipient weight had a 95% likelihood of neutrophil and platelet recovery by day +15. Baseline (precytokine) CD34+ cells per milliliter of donor peripheral blood and total G-CSF dose (donor weight x 10 micrograms/kg) correlated with the number of CD34+ cells collected (R2 = .24 and P = .0009, and R2 = .24 and P < .0001, respectively). Donor age and sex did not effect mobilization. CONCLUSION: Following allogeneic PBSC transplant, patie...