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

• Published in: European journal of cancer (1990) Vol. 40; no. 8; pp. 1199 - 1207
• Main Authors: Nieboer, P., de Vries, E.G.E., Vellenga, E., van der Graaf, W.T.A., Mulder, N.H., Sluiter, W.J., de Wolf, J.Th.M.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2004; Elsevier
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Biological and medical sciences; Blood Platelets; Erythrocyte Volume; Female; Graft Survival; Granulocytes; Haematological recovery; Haematopoiesis; Hematologic Neoplasms - therapy; Hemoglobins - analysis; High-dose chemotherapy; Humans; Leukocyte Count; Leukocytes; Long-term; Male; Medical sciences; Middle Aged; Multivariate Analysis; Peripheral Blood Stem Cell Transplantation - methods; Peripheral stem-cell transplantation; Pharmacology. Drug treatments; Platelet Count; Treatment Outcome; Tumors; Long-term; High-dose chemotherapy; Haematological recovery; Peripheral stem-cell transplantation; Haematopoiesis; Antineoplastic agent; Stem cell; Hematopoietic cell; Pharmacology; Malignant tumor; Long term; Recovery; Chemotherapy; Cancerology; Treatment; Hematopoiesis; Graft; High dose
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2004.01.029

Peripheral blood counts and factors influencing haematological recovery in 98 patients with a relapse-free survival of ⩾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.