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Effect of CD34+ cell dose on hematopoietic reconstitution and outcome in 508 patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation

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 tra...

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Main Authors: Klaus, Jens (Author) , Herrmann, Doris (Author) , Breitkreutz, Iris (Author) , Hegenbart, Ute (Author) , Mazitschek, Uta (Author) , Egerer, Gerlinde (Author) , Cremer, Friedrich Walter (Author) , Lowenthal, Ray M. (Author) , Hüsing, Johannes (Author) , Frühauf, Stefan (Author) , Möhler, Thomas (Author) , Ho, Anthony Dick (Author) , Goldschmidt, Hartmut (Author)
Format: Article (Journal)
Language:English
Published: [January 2007]
In: European journal of haematology
Year: 2007, Volume: 78, Issue: 1, Pages: 21-28
ISSN:1600-0609
DOI:10.1111/j.0902-4441.2006.t01-1-EJH2895.x
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1111/j.0902-4441.2006.t01-1-EJH2895.x
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0902-4441.2006.t01-1-EJH2895.x
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Author Notes:Jens Klaus, Doris Herrmann, Iris Breitkreutz, Ute Hegenbart, Uta Mazitschek, Gerlinde Egerer, Friedrich W. Cremer, Ray M. Lowenthal, Johannes Huesing, Stefan Fruehauf, Thomas Moehler, Anthony D. Ho, Hartmut Goldschmidt
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Summary: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 × 106 unselected CD34+ cells/kg, 116 patients a low dose (LD−) of <3.00 × 106 CD34+ cells/kg. Among the patients treated with CD34+ selected PBSC, 34 received ≥6.50 × 106 CD34+ cells/kg (HD+) and 16 <3.00 × 106 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 × 109/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 × 109/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 × 106 CD34+ cells/kg. As 60% of our pretreated patients are able to collect ≥5.00 × 106 CD34+ cells/kg within a single leukapheresis, division into two or more freezing bags allows safe tandem transplantation in the majority of MM patients.
Item Description:Das Pluszeichen im Titel ist hochgestellt
Frontdoor: First published: 22 November 2006
Gesehen am 26.10.2021
Physical Description:Online Resource
ISSN:1600-0609
DOI:10.1111/j.0902-4441.2006.t01-1-EJH2895.x

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