Abstract
Introduction: Autologous stem cells transplantation (ASCT) is a treatment option used in various hematological malignancies. ASCT can prolong disease free survival, improve survival, and may be curative. We investigated the variables affecting engraftment among patients treated with high dose-chemotherapy and ASCT.
Methods: 364 adult patients underwent 419 ASCT from 2001 to 2016, at the American University of Beirut Medical Center. There were 207 males and 157 females, with a median age of 45 years (17-74). The cohort included 126 multiple myeloma (MM), 120 non-Hodgkin lymphoma, and 108 Hodgkin lymphoma, while 10 patients had other malignancies. All patients received high-dose chemotherapy regimens without total body irradiation. The median time from diagnosis to first transplant is 11.9 months (range 2-288). The median number of apheresis was 1 (range 1-5).
Results: The median number of infused CD34+ cells was 5.8x106/kg (range 0.71-24.9) which contained DMSO at a median dose of 0.2 g/kg BW (range 0.0375-0.91). Patients exhibited an absolute neutrophil count (ANC) recovery of ≥0.5x109/L at a median of 10 days (range 1-97). Platelet recovery to ≥20x109/L occurred at a median of 15 days (range 7-46). Status of the disease at transplant was: 130 patients (31%) were in complete remission (CR), 242 (58%) in partial remission (PR), and 47 (11%) patients were in relapse or progressive disease.
The findings of univariate and multivariate analyses are summarized in Table 1. Diagnosis other than MM, low DMSO dose (< 0.2 g/kg BW), and high infused CD34+ cell count (>6x106/kg) were associated with engraftment of neutrophils within 10 days from stem cell infusion. Low DMSO dose and high infused CD34+ cell count were associated with engraftment of platelets within 15 days.
Conclusion: Our results imply that the infused CD34+ cell count and the DMSO dose are important predictors of hematopoietic engraftment, namely neutrophil and platelet engraftment. These findings need to be verified in larger scale studies.
No relevant conflicts of interest to declare.
