Original scientific paper
Collection and Composition of Autologous Peripheral Blood Stem Cells Graft in Patients with Acute Myeloid Leukemia: Influence on Hematopoietic Recovery and Outcome
Mirela Raos
; Department of Transfusion Medicine and Cellular Therapy, University Hospital Center Zagreb, Zagreb, Croatia
Damir Nemet
; University of Zagreb, School of Medicine, Zagreb, Croatia
Ines Bojanić
; Department of Transfusion Medicine and Cellular Therapy, University Hospital Center Zagreb, Zagreb, Croatia
Dubravka Sertić
; Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Drago Batinić
; University of Zagreb, School of Medicine, Zagreb, Croatia
Vesna Dušak
; Department for Quantitative Methods, Faculty of Organisation and Informatics, University of Zagreb,Varaždin, Croatia
Klara Dubravčić
; Division of Immunology, Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
Sanja Mazić
; Department of Transfusion Medicine and Cellular Therapy, University Hospital Center Zagreb, Zagreb, Croatia
Ranka Serventi-Seiwerth
; Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Mirando Mrsić
; University of Zagreb, School of Medicine, Zagreb, Croatia
Branka Golubić-Ćepulić
; Department of Transfusion Medicine and Cellular Therapy, University Hospital Center Zagreb, Zagreb, Croatia
Boris Labar
; University of Zagreb, School of Medicine, Zagreb, Croatia
Abstract
Hematopoietic stem cell (HSC) transplantation is a standard approach in the treatment of hematological malignant diseases. For the last 15 years the main source of cells for trasplantation have been peripheral blood stem cells (PBSC). With the availability of hematopoietic growth factors and understanding the advantages of treatment with PBSC, the application of bone marrow (BM) was supplanted. The aim of this survey was to explore the success of PBSC collection, the factors which influence the success of PBSC collection, the composition and the quality of graft and their infuence on hematopoietic recovery and outcome after transplantation in patients with acute myeloid leukemia (AML). PBSC were collected by the method of leukapheresis after applying a combination of chemotherapy and growth factors or only growth factors. The quality of graft was determined with the clonogenic progenitor cell assay and with the flow citometry analysis. Of the total 134 patients with AML, who were submitted to HSC mobilization, the collection was successful in 78 (58.2%) patients. The collection was more successful after the first than after the second attempt of HSC mobilization (49% vs. 11%). The criteria for effective mobilization were the number of leukocytes >3´109/L and the concentration of CD34+ cells >20´103/mL in the peripheral blood on the first day of leukapheresis. The number of CD34+ cells infused had the strongest impact on hematopoietic recovery. We noted significantly faster hematological recovery of neutrophils and platelets, fewer number of transfused units of red blood cells and platelets, shorter duration of the tranfusion support, shorter treatment with intravenous antibiotic therapy and shorter hospitalization after PBSC compared to BM transplantation. These advantages could provide their standard application in the treatment of patients with AML.
Keywords
acute myeloid leukemia; autologous peripheral blood stem cells; graft composition; stem cell transplantation
Hrčak ID:
51250
URI
Publication date:
10.3.2010.
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