Reprise HéMatopoïéTique En Fonction Du Nombre De Cellules Cd34+ AutogrefféEs: ÉTude RéTrospective Chez 66 Patients Atteints D'HéMopathies Malignes

Abstract

SummaryEngraftment in relation to infused CD34+ cell number was retrospectively analysed in 66 patients with hematological diseases: non-Hodgkin’s lymphoma (n = 33), multiple myeloma (n = 21), acute myelogenous leukemia (n = 7), Hodgkin’s disease (n = 4) and myelodysplastic syndrome (n = 1). Progenitor cells were mobilized with rhG-CSF, alone or in association with chemotherapy. The cells were harvested by leukapheresis until at least 2 Ö 106 CD34+/kg body weight were obtained. A total of 194 leukaphereses were performed (median = 3 per patient, range 1 - 9). A median of 3.40 × 108 nucleated cells/kg (range 0.31 - 27.59) and a median of 7.15 × 106 CD34+ cell /kg (range 1.31 - 115.70) were transplanted. Regardless of transfusional support or patient diagnosis, engraftment was rapid in patients who had received > 5 × 106 CD34+ cell /kg. In this case, absolute neutrophil blood count > 0.5 × 109/1 was obtained on day 12 post graft (range 7-19) and platelet count ≥ 20 × l09/l was also reached after the same median time interval (range 8 - 121). From the present results, a minimal threshold of 5 × 106 CD34+ cell /kg appears to be suitable for providing rapid and com-plete hematopoietic reconstitution in patients exposed to high doses of chemotherapy with or without total body irradiation. Furthermore, administration of rhG-CSF during post-graft period significantly decreased the neutrophil time recovery (P = 0.002) but not that of platelets (P > 0.05).