Donor marrow progenitors (CFU-Mix, BFU-E) and (CFU-GM) and haemopoietic engraftment following HLA matched sibling bone marrow transplantation

Abstract

Bone marrow multipotent (CFU-Mix) and unipotent (CFU-GM and BFU-E) progenitor cells in the donor marrow inoculums were measured in 24 histocompatible sibling bone marrow transplants. The number of donor marrow nucleated cells, CFU-Mix, CFU-GM and BFU-E given per kilogram (kg) of recipient's body weight were 2.4 ± 0.6 × 10 8, 3.6 ± 4.2 × 10 3, 4.9 ± 3.3 × 10 −4 and 4.3 ± 4.1 × 10 4 respectively (mean ± S.D.). Fast engraftment patients, as assessed by rise in peripheral blood neutrophils (⩾0.5 and (⩾1.0 × 10 9/ l) and platelets (>20 and >50 × 10 9/1), received a significantly greater amount of CFU-Mix/kg (>3 × 10 3/kg, p < 0.025) and CFU-GM/kg (>3 × 10 4/kg, p < 0.05) except for plat ⩾20 × 10 9/1) than the slow recovery patients. Significant correlations were found between the donor CFU-Mix/kg infused and neutrophil recovery to 1 × 10 9/ l and platelet to 50 × 10 9/ l (Spearman's rank correlation coefficient r = 0.38, p = 0.04 and r = 0.58, p = 0.003, respectively). The amount of donor CFU-GM/kg given also correlated significantly to neutrophil (1 × 10 9/ l) and platelet (50 × 10 9/ l) recovery, ( r = 0.33 and r = 0.37, respectively, p ⩽ 0.05). There was no association between BFU-E, and marrow nucleated cells infused per kg and haemopoietic recovery. A number of clinical parameters were also examined to determine other factors that may influence the rate of engraftment. Acute graft vs host disease (⩾ grade II) and methotrexate therapy post-transplant delayed the platelet regeneration. The results of the present report indicate that in vitro measurement of donor CFU-Mix and CFU-GM progenitors infused, correlate with the speed of granulocyte and platelet recovery in clinical allogeneic bone marrow transplants.