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

• Verfasst von: Klaus, Jens [VerfasserIn]
• Verfasst von: Herrmann, Doris [VerfasserIn]
• Verfasst von: Breitkreutz, Iris [VerfasserIn]
• Verfasst von: Hegenbart, Ute [VerfasserIn]
• Verfasst von: Mazitschek, Uta [VerfasserIn]
• Verfasst von: Egerer, Gerlinde [VerfasserIn]
• Verfasst von: Cremer, Friedrich Walter [VerfasserIn]
• Verfasst von: Lowenthal, Ray M. [VerfasserIn]
• Verfasst von: Hüsing, Johannes [VerfasserIn]
• Verfasst von: Frühauf, Stefan [VerfasserIn]
• Verfasst von: Möhler, Thomas [VerfasserIn]
• Verfasst von: Ho, Anthony Dick [VerfasserIn]
• Verfasst von: Goldschmidt, Hartmut [VerfasserIn]
• Titel: Effect of CD34+ cell dose on hematopoietic reconstitution and outcome in 508 patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation
• Verf.angabe: 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
• E-Jahr: 2007
• Jahr: [January 2007]
• Umfang: 8 S.
• Illustrationen: Illustrationen
• Fussnoten: Das Pluszeichen im Titel ist hochgestellt ; Frontdoor: First published: 22 November 2006 ; Gesehen am 26.10.2021
• Titel Quelle: Enthalten in: European journal of haematology
• Ort Quelle: Oxford : Wiley-Blackwell, 1987
• Jahr Quelle: 2007
• Band/Heft Quelle: 78(2007), 1 vom: Jan., Seite 21-28
• ISSN Quelle: 1600-0609
• DOI: doi:10.1111/j.0902-4441.2006.t01-1-EJH2895.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: autologous transplantation
• Sach-SW: hematopoietic reconstitution
• Sach-SW: multiple myeloma
• K10plus-PPN: 1775299910

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 × 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.