Relationship of CD34+ cell dose to early and late hematopoiesis following autologous peripheral blood stem cell transplantation
We evaluated early and late hematopoietic reconstitution in 27 patients with advanced lymphoma, Hodgkin’s disease, and breast or ovarian cancer after treatment using high-dose/myeloablative conditioning regimens and autologous peripheral blood stem cell (PBSC) transplantation. Eighteen patients (67%) received G-CSF 5 μ g/kg/day following chemotherapy and nine (33%) were mobilized using G-CSF alone. Each patient had 7 × 108 mononuclear cells (MNC) per kg collected. G-CSF was administered post-PBSC infusion. While all patients showed prompt granulocyte recovery by day 14, platelet recovery failed to occur in four (15%) heavily pretreated patients with non-Hodgkin’s lymphoma. Retrospective analysis in 17 patients revealed that the infused number of CD34 surface antigen-positive cells correlated with time to granulocyte (r = 0.59, P = 0.012) and platelet (r = 0.58, P = 0.021) recovery. Patients receiving the higher numbers of CD34+ cells had consistently better hematologic parameters at all times examined. At 180 days post-transplant, the median Hb level was 124 g/l vs 88 g/l (P = 0.004); platelet count was 202 × 109/l vs 25 × 109/l (P = 0.004); and neutrophil count was 3100 × 106/l vs 1400 × 106/l (P = 0.15). Hemoglobin strongly correlated with the CD34+ cell dose at 360 days (r = 0.90, P = 0.01). We conclude that graft CD34+ cell content appears to be an indicator of the quality of late as well as early hematopoietic function.