Factors influencing haematological recovery following high-dose chemotherapy and peripheral stem-cell transplantation for haematological malignancies; 1-year analysis

Eur J Cancer. 2004 May;40(8):1199-207. doi: 10.1016/j.ejca.2004.01.029.

Abstract

Peripheral blood counts and factors influencing haematological recovery in 98 patients with a relapse-free survival of > or =1 year treated with high-dose chemotherapy (HDC) and peripheral stem-cell transplantation (PSCT) for haematological malignancies were analysed. One year after PSCT full haematological recovery was demonstrated for haemoglobin (Hb) in 47% of patients, for the white blood cell count (WBC) in 94%, and for platelets in 64%; 39% had a trilineage recovery. In the multivariate analysis, recovery was influenced by age (P=0.002), number of reinfused CD34+ cells (P=0.016), Hb at start of HDC (P=0.001), and platelets at start of HDC (P=0.008). One year following PSCT, 61% of patients still have subnormal values in one or more haematopoietic cell lineage, suggesting a limited bone-marrow reserve. Long-term recovery is highly dependent on age, blood counts at start of HDC and number of reinfused CD34+ cells without a threshold, all reflecting the residual function of bone marrow before HDC. Reinfusing more CD34+ cells can accelerate long-term haematological recovery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Blood Platelets
  • Erythrocyte Volume
  • Female
  • Graft Survival
  • Granulocytes
  • Hematologic Neoplasms / therapy*
  • Hemoglobins / analysis
  • Humans
  • Leukocyte Count
  • Leukocytes
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peripheral Blood Stem Cell Transplantation / methods*
  • Platelet Count
  • Treatment Outcome

Substances

  • Hemoglobins