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Prediction of engraftment after autologous peripheral blood progenitor cell transplantation: CD34, colony‐forming unit–granulocyte‐macrophage, or both?
Author(s) -
Jansen Eva M.,
Hanks Susan G.,
Terry Colin,
Akard Luke P.,
Thompson James M.,
Dugan Michael J.,
Jansen Jan
Publication year - 2007
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2007.01195.x
Subject(s) - progenitor cell , cd34 , transplantation , multiple myeloma , colony forming unit , medicine , granulocyte , leukapheresis , myeloid , immunology , andrology , stem cell , biology , genetics , bacteria
BACKGROUND: The rate of hematologic recovery after peripheral blood progenitor cell (PBPC) transplantation is influenced by the dose of progenitor cells. Enumeration of cells that express CD34+ on their surface is the most frequently used method to determine progenitor cell dose. In vitro growth of myeloid progenitor cells (colony‐forming unit–granulocyte‐macrophage [CFU‐GM]) requires more time and resources, but may add predictive information. STUDY DESIGN AND METHODS: A series of 323 patients, who underwent autologous PBPC transplantation for multiple myeloma, malignant lymphoma, or locally advanced breast cancer, were studied for the effect of CD34+ dose and CFU‐GM dose on hematologic recovery. Measures for engraftment were days to absolute granulocyte and platelet (PLT) counts to greater than 500 per μL and than 20 × 10 9 per L, respectively, and number of PLT transfusions and red cell units required. RESULTS: The CD34+ dose had a median of 8.4 × 10 6 per kg, and the CFU‐GM dose a median of 84.9 × 10 4 per kg. The CD34+ and CFU‐GM doses showed significant correlation (R = 0.63; p < 0.0001) but a wide variation in the ratio of CD34+ and CFU‐GM. Both CD34+ and CFU‐GM doses had significant correlation with the measures of engraftment, but for all measures the relationship of CD34+ was stronger. Multivariate analysis and subgroup analysis of patients receiving CD34+ doses of less than 5 × 10 6 per kg also did not reveal an independent predictive value for CFU‐GM. CONCLUSION: 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.