In:
European Journal of Haematology, Wiley, Vol. 78, No. 1 ( 2007-01), p. 21-28
Abstract:
Background: We analyzed the hematopoietic reconstitution and outcome of 508 patients with multiple myeloma (MM) with respect to the number of CD34 + cells reinfused at our center. Patients and methods: Each cohort of 390 patients (unselected CD34 + cell transplant) and 118 patients (CD34 + selected transplant) was divided into four subgroups. Among the 390 transplantations, 86 patients received a high dose (HD − ) of ≥6.50 × 10 6 unselected CD34 + cells/kg, 116 patients a low dose (LD − ) of 〈 3.00 × 10 6 CD34 + cells/kg. Among the patients treated with CD34 + selected PBSC, 34 received ≥6.50 × 10 6 CD34 + cells/kg (HD + ) and 16 〈 3.00 × 10 6 CD34 + cells/kg (LD + ). Results: HD − patients experienced a reduced median time to leukocyte (13 d vs. 14 d) ( P 〈 0.001) and platelet reconstitution 〉 20 × 10 9 /L (10 d vs. 12 d) ( P 〈 0.001). Similarly, HD + showed a reduced median time to leukocyte (12 d vs. 15 d) ( P 〈 0.001) and platelet recovery 〉 20 × 10 9 /L (10 d vs. 11 d) ( P = 0.058). CD34 + cell‐dose was significant for long‐term platelet recovery at day 360 (unselected transplant P = 0.015, selected transplant P = 0.023). Number of transplanted CD34 + cells had no significant impact on transplant related mortality, overall survival or CR/PR rates within 100 d. In terms of supportive care the differences of high‐/low‐dose grafts were minimal. Conclusions: These results confirm that high doses of CD34 + PBSC shorten hematopoietic reconstitution and reduce hospitalization. Nevertheless secure engraftment results from transplantation of 2.00–3.00 × 10 6 CD34 + cells/kg. As 60% of our pretreated patients are able to collect ≥5.00 × 10 6 CD34 + cells/kg within a single leukapheresis, division into two or more freezing bags allows safe tandem transplantation in the majority of MM patients.
Type of Medium:
Online Resource
ISSN:
0902-4441
,
1600-0609
DOI:
10.1111/ejh.2007.78.issue-1
DOI:
10.1111/j.0902-4441.2006.t01-1-EJH2895.x
Language:
English
Publisher:
Wiley
Publication Date:
2007
detail.hit.zdb_id:
2027114-1