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

Abstract

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 x 10(6) CD34+ cells/kg. As 60% of our pretreated patients are able to collect > or =5.00 x 10(6) CD34+ cells/kg within a single leukapheresis, division into two or more freezing bags allows safe tandem transplantation in the majority of MM patients.

SCT without growth factor in multiple myeloma: engraftment kinetics, bacteremia and hospitalization

“…The practice of not administering growth factor after stem cell infusion is standard in European countries. [22][23][24][25] This study has several limitations. The groups were not contemporaneous, in that the patients who received filgrastim underwent transplant before April 2008.…”

Transplantation without growth factor: engraftment kinetics after stem cell transplantation for primary systemic amyloidosis (AL)

“…The number of transplanted CD34 þ cells had no effect on the rate of mortality or overall survival. 16 In this cohort, no patients received G-CSF after high-dose chemotherapy and transplantation, which is the customary regimen in Europe. In our study, the infusion of more than 3.0 Â 10 6 CD34 þ cells appeared to have at least as much effect on engraftment times as the use of filgrastim after transplantation.…”

The impact of CD34+ cell dose on engraftment after SCTs: personalized estimates based on mathematical modeling

“…As various diseases are treated by PBSC transplantations (PBSCT), we focus on trial data including different diagnoses. We consider the following scenarios used in current clinical practice: autologous PBSCT with and without post transplant cytokine administration, 19,27 HLA-identical allogeneic PBSCT with 28,29 and without 30,31 post transplant cytokine administration, haplo-identical PBSCT 32,33 and umbilical cord blood transplantation. 34 We also consider the impact of reduced conditioning regimens.…”

“…35 To compare simulations of leukocyte counts after autologous PBSCT with patient data, we use single patient data of one arm (containing patients treated with selected PBSCs) of the trial from. 19 For this task, we obtained original data of representative patients from Klaus et al 19 …”

“…[16][17][18] In almost every trial, there exist patients with recovery times distant from average. The dose of transplanted cells has an impact on the time to neutrophil reconstitution 2,19 and is a tunable parameter; therefore, it is important to know whether slowly reconstituting patients might benefit from increased numbers of transplanted cells. As such patients cannot be identified before transplantation, it is difficult to apply prospective clinical trials.…”