Autologous stem cells: volume of transplants, cytopenia and transfusion therapy
Hematopoietic recovery and the need for blood components have been evaluated in 169 patients with autologous hematopoietic stem cell transplantation. The patients were divided into 2 groups: with autoimmune (n = 87) and hematological (n = 82) diseases. More than 2 * 106/kg CD34+-cells have been mobilized in 106 patients, and less than 2 * 106/kg CD34+-cells have been mobilized in 63 patients. In 21 % patients with autoimmune diseases anemia developed below 80 g/l. A quarter of patients with anemia below 80 g/ l needed in one unit of red blood cells transfusion. In patients who received CD34+-cells more than 2,0 * 106/kg hemoglobin recovery above 80 g/l occured in four days earlier than patients who received fewer cells. In hematological patients who received CD34+-cells more than 2,0 * 106/kg, the risk of anemia requiring blood transfusion of nearly 20 % higher with a corresponding increase in the number of repeated red blood cells transfusions compared to recipients fewer stem cells. Patients with autoimmune diseases have received more than 2,0 * 106/kg of stem cells, less susceptible to the development of thrombocytopenia less than 10 * 109, and therefore at risk of platelet transfusion. Hematological recipients small number of stem cells more than twice as likely to get three or more units of platelet transfusions. In the group of patients who received more than 2,0 * 109 of CD34+-cells and platelets recovery is higher than 10 * 20 and 109 occurs much earlier.