Premium
High‐dose CD34+ cells are not clinically relevant in reducing cytopenia and blood component consumption following myeloablative therapy and peripheral blood progenitor cell transplantation as compared with standard dose
Author(s) -
Lefrère François,
Delarue Richard,
Somme Dominique,
Levy Vincent,
Damaj Gandhi,
Tu Angela,
Porcher Raphael,
Audat Françoise,
Boulat Claire,
CavazzanaCalvo Marine,
Buzyn Agnès,
Belanger Coralie,
Maillard Natacha,
Hermine Olivier,
Varet Bruno
Publication year - 2002
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1525-1438.2002.00060.x
Subject(s) - medicine , cd34 , platelet , cytopenia , chemotherapy , gastroenterology , progenitor cell , urology , platelet transfusion , multiple myeloma , lymphoma , surgery , stem cell , bone marrow , genetics , biology
BACKGROUND : No agreement exists about the number of autologous peripheral blood progenitor cells (PBPCs) to transfuse for optimal hematologic recovery after high‐dose chemotherapy. STUDY DESIGN AND METHODS : To determine CD34+ cell dosage following high‐dose chemotherapy (in terms of hematologic recovery and blood component consumption), the effects of two schedules of CD34+ cell transfusions in a cohort of patients with myeloma or non‐Hodgkin's lymphoma were examined. Forty patients (Group 1) received between 2.5 and 5 × 10 6 CD34+ cells per kg, with a median of 3.4 × 10 6 per kg following high‐dose chemotherapy, and 40 patients (Group 2), selected to match Group 1 for age, diagnosis, prior therapies, and procedure for PBPC mobilization, received a dose of CD34+ cells >5 × 10 6 per kg, with a median of 8.4 × 10 6 per kg (5‐33). RESULTS : The median number of days to achieve a neutrophil count of >0.5 × 10 9 per L and unsupported platelets of >20 × 10 9 per L was identical for the two groups, but the time required to reach 1.5 × 10 9 neutrophils per L and 50 × 10 9 platelets per L was greatly delayed in Group 1. No significant difference was observed for the median number of RBC and platelet transfusions, or for the proportion of patients in each group that did not require either platelet or RBC transfusions. CONCLUSION : Our data confirm a dose–response relationship between CD34+ cell dose transfused and time to hematologic recovery after high‐dose chemotherapy. However, the minimal Hb and platelet counts for transfusion independence in the two groups are similar when the CD34+ cell dose is greater than 5 × 10 6 CD34+ cells per kg. Therefore, our data suggest that it is not necessary to go on with apheresis procedures after 5 × 10 6 CD34+ cells per kg are harvested to sustain one high‐dose chemotherapy.