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Indian Journal of Medical and Paediatric Oncology
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Year : 2003  |  Volume : 24  |  Issue : 3  |  Page : 9-14

Autologous peripheral blood stem cell transplantation : a study of engraftment kinetics

Dept. of Medical Oncology, IRCH AIIMS, New Delhi, India

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R Bedi
Dept. of Medical Oncology, IRCH AIIMS, New Delhi, India

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Source of Support: None, Conflict of Interest: None

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High dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT) is used for treatment of both haematological and solid cancers. Mononuclear cell Count (MNC), granulocyte macrophage-colony forming units (CFU-GM) or CD34 + cells are surrogate markers for haematopoietic capacity of infused (transplanted) stem cells. We studied correlation of these markers with post-engraftment kinetics. Methods: Twenty one patients [multiple myeloma, n=13, Hodgkin's disease -3, Non Hodgkin's lymphoma-2, metastatic breast cancer-2 and germ cell tumour of testis-1] undergoing ASCT were studied. Mononuclear cell counts were done manually, CFU-GM assays were performed using standard 14 day culture method. CD 34 + cell count were done using flow cytometry. Spearman correlation coefficient test was performed to determine factors that affect the kinetics of granulocyte and platelet recovery following infusion of peripheral blood stem cells i.e. MNc, CFU-GM and CD34 + cell assays. Results: Seventeen of 21 patients engrafted. Median CD34 + cell count was 4.91 *10 6 cells/ kg (range, 1.21 to 63.1), MNC count was 3.55*10 8/kg (range, 1.77-19.29) and CFU-GM was 35.05*10 4 colonies/kg (range, 10.75-110). Following analysis, CFU-GM colony count of the infused cells correlated with neutrophil recovery (p=0.03) but not with platelet recovery (p=0.09). MNC and CD34 + cell counts did not influence either neutrophil or platelet recovery. Four patients died, one prior to ASCT, due to progressive disease and three, due to transplant related toxicity. Conclusion: CFU-GM Colony assay is an important predictor of neutrophil recovery after ASCT regardless of disease or mobilization technique. Further experience is needed to predict the effect of CD34 + cell count on engraftment kinetics.

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