High CD34+ cell dose promotes faster platelet recovery after autologous stem cell transplantation for acute myeloid leukemia
High CD34+ cell dose promotes faster platelet recovery after autologous stem cell transplantation for acute myeloid leukemia
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DOI：
10.1016/s1083-8791(03)00232-5
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发表时间：
2003-10-01
影响因子：
4.3
通讯作者：
Linker, C
中科院分区：
文献类型：
--
作者：
Gunn, N;Damon, L;Linker, C
我们研究了58例急性髓性白血病首次缓解患者的血小板植入情况，这些患者接受自体干细胞移植（ASCT）治疗，以确定CD 34（+）细胞剂量>10 × 10（6）/kg是否与血小板植入更快相关。我们比较了接受CD 34（+）剂量5 - 10 × 10（6）/kg（标准剂量ASCT）和接受剂量大于或等于10 × 10（6）/kg（高剂量[HD] ASCT）的患者的植入率。我们还研究了中性粒细胞植入率以及血小板和红细胞输注需求。在多变量校正模型中，接受HD-ASCT的受试者血小板恢复至大于或等于20，000/穆尔的比率是接受HD-ASCT的受试者的4倍（风险比[HR]，4.1;置信区间[CI]，1.8-9.2; P = 0.001），中位恢复时间为14天与28天。血小板恢复至大于或等于50，000/穆尔的比率高2倍（HR，2.1; CI，1.3-5.9; P = 0.01），中位恢复时间为19天对46天。接受HD-ASCT的受试者中血小板恢复更快导致需要更少的血小板输注（平均输注量，3.7 vs 9.8; P = .005）。尽管没有统计学显著性，但调整模型中的中性粒细胞恢复数据表明HD-ASCT组中有类似的效果，在中性粒细胞绝对计数>500/穆尔时植入时间更快（中位数，9.2 vs 12天; HR，1.6; CI，0.69-3.5; P = 0.29）和中性粒细胞绝对计数>1000/穆尔（中位数，9.5 vs 12天; HR，1.3; CI，0.56-2.8; P = 0.58）。接受HD-ASCT的受试者需要较少的红细胞输注（4.0 vs 9.8单位; P = 0.01）。我们的研究结果表明，CD 34（+）细胞剂量>10 × 10（6）/μ g CD 34（+）导致更快的植入和更少的红细胞和血小板输注。(C)2003年美国血液和骨髓移植学会。
We studied platelet engraftment in 58 patients with acute myeloid leukemia in first remission treated with autologous stem cell transplantation (ASCT) to determine whether CD34(+) cell doses >10 x 10(6)/kg were associated with faster platelet engraftment. We compared engraftment rates in patients receiving CD34(+) doses between 5 and 10 x 10(6)/kg (standard-dose ASCT) with those receiving doses greater than or equal to10 x 10(6)/kg (high-dose [HD] ASCT). We also studied neutrophil engraftment rates and platelet and red blood cell transfusion requirements. In multivariate adjusted models, the rate of platelet recovery to greater than or equal to20,000/muL was 4-fold greater among subjects who received HD-ASCT (hazard ratio [HR], 4.1; confidence interval [CI], 1.8-9.2; P = .001), with median recovery times of 14 versus 28 days. The rate of platelet recovery to greater than or equal to50,000/muL was 2-fold greater (HR, 2.1; CI, 1.3-5.9; P = .01), with median recovery times of 19 versus 46 days. Faster platelet recovery resulted in the need for fewer platelet transfusions among the subjects who received HD-ASCT (mean transfusions, 3.7 versus 9.8; P = .005). Although not statistically significant, neutrophil recovery data in the adjusted model suggested a similar effect in the HD-ASCT group, with faster engraftment times at absolute neutrophil counts >500/muL (median, 9.2 versus 12 days; HR, 1.6; CI, 0.69-3.5; P = .29) and absolute neutrophil counts >1000/muL (median, 9.5 versus 12 days; HR, 1.3; CI, 0.56-2.8; P = .58). Subjects who received HD-ASCT required fewer red blood cell transfusions (4.0 versus 9.8 units; P = .01). Our findings suggest that CD34(+) cell doses >10 x 10(6)/mug CD34(+) result in faster engraftment and fewer red blood cell and platelet transfusions. (C) 2003 American Society for Blood and Marrow Transplantation.