Features of the engraftment of allogeneic hematopoietic stem cells using reduced-intensity conditioning regimens

Leuk Lymphoma. 2001 Jun;42(1-2):145-50. doi: 10.3109/10428190109097686.

Abstract

The features of the engraftment in 26 patients allografted using reduced-intensity conditioning regimen (8 with chronic myelogenous leukemia, 6 with acute myelogenous leukemia, 9 with acute lymphoblastic leukemia, 1 with hybrid acute leukemia, 1 with myelodysplasia and 1 with thalassemia major) were analyzed. Patients received a median of 10 x 10(8)/Kg mononuclear cells (range 1.6 to 22.9), and a median of 4.2 x 10(6)/Kg CD34 cells (range 0.3 to 14). There was a linear correlation between the number of infused mononuclear cells (MNC) and that of CD34 cells (r = 0.78, p = 0.002). Three patients (11%) failed to engraft; in those who engrafted, the median time to achieve > 500 granulocytes was 11 days (range 10 to 22), and the median time to achieve > 10,000 platelets was 12 days (range 10 to 41). The three patients who failed to engraft received less than 5 x 10(8)/Kg MNC (1.6, 4.6 and 4.9) and less than 0.5 x 10(6)/Kg CD34; however, five of eight patients who received less than 5 x 10(8)/Kg MNC still engrafted successfully. On the other hand, all the patients who received less than 0.5 x 10(6)/Kg CD34 cells failed to engraft. Within the group of patients who engrafted, it was found that those who received more than 7 x 10(6)/Kg CD34+ cells tended to earlier recover > 20 x 10(9)/L platelets (p = 0.02), and > 0.5 x 10(9)/L neutrophils (p = 0.06) before day 15, than those who received less than 7 x 10(6)/Kg CD34+ cells. No such association could be established between the number of MNC and the time for recovery. In these patients allografted using reduced-intensity conditioning regimens, the target doses of hematopoietic cell used were similar to those described for conventional allografts: The number of CD34 infused cells was significantly related to the possibility of failure to engraft and to the recovery rate of the hemopoiesis.

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD34
  • Blood Cell Count
  • Child
  • Child, Preschool
  • Female
  • Graft Survival*
  • Hematologic Neoplasms / therapy
  • Hematopoiesis
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Leukapheresis / standards
  • Leukocyte Count
  • Leukocytes, Mononuclear
  • Male
  • Middle Aged
  • Time Factors
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous / methods
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives

Substances

  • Antigens, CD34
  • Immunosuppressive Agents
  • Vidarabine
  • fludarabine