Influential Factors for Engraftment in Autologous Peripheral Hematopoietic Stem Cell Transplantation (APBSCT)

Abstract

Background: Autologous peripheral hematopoietic stem cell transplantation (APBSCT) has been widely used to treat various types of hematological disorders, metabolic diseases and congenital immuno- deficiency. Hematopoietic recovery is important because prolonged duration of neutropenia and thrombo- cytopenia is associated with a higher risk of infection, bleeding and treatment related mortality. Many investigators have studied the factors that affect hematopoietic recovery after stem cell transplantation. Methods: We retrospectively investigated the factors influencing hematopoietic engraftment in 112 pa- tients with hematological malignancies and solid tumors who received APBSCT. We evaluated the gender, age, CD34+ cell number, conditioning regimens, and the type of tumor and their association with neu- trophil and platelet engraftment. Results: Post-transplant neutrophil engraftment (>500/μL) required a median of 11 days (range 6∼50) and platelet engraftment 12 (range 1∼78) days (>20,000/μL). The univariate analysis showed that the factors that positively affected hematopoietic recovery were: the type of conditioning regimens such as BEAM (BCNU, etoposide, cytosine arabinoside, melphalan) and BEAC (BCNU, etoposide, cytosine arabi- noside, cyclophosphamide) versus BC (busulfan, cyclophosphamide ), the CD34 + cell number and the disease diagnosis such as multiple myeloma versus acute myelogenous leukemia. The multivariate analysis showed only the CD34 + cell number (5∼10×10 6 /kg) to be significantly associated with early neutrophil and platelet engraftment (P<.001). Conclusion: These findings suggest that measurement of the CD34 + cell count may be sufficient to predict