Wang Shirong, Nademanee Auayporn, Qian Dajun, Dagis Andrew, Park Hyun-Soon, Fridey Joy, Smith Eileen, Snyder David, Somlo George, Stein Anthony, Rosenthal Joseph, Falk Peter, Kogut Neil, Palmer Joycelynne, Gaal Karl, Kim Young, Bhatia Ravi, Yuan Shan, Kay Candace, Weiss Lawrence, Forman Stephen
Department of Transfusion Medicine, Division of Pathology, City of Hope National Medical Center, Duarte, California 91010, USA.
Transfusion. 2007 Dec;47(12):2207-16. doi: 10.1111/j.1537-2995.2007.01448.x. Epub 2007 Aug 21.
The successful mobilization and collection of hematopoietic stem cells are dependent on a number of clinical factors such as previous chemotherapy and disease stage. The aim of this retrospective study was to determine whether the effectiveness of mobilization and collection is an independent prognostic factor for autologous stem cell transplantation outcome.
A total of 358 patients who received transplants from January 2003 to December 2004 (201 male and 157 female patients, ages from 2.7 to 77.3 years with median of 53 years of age) underwent autologous hematopoietic stem cell collection after mobilization with granulocyte-colony-stimulating factor (G-CSF) or G-CSF plus chemotherapy priming. This retrospective study included patients with diagnoses of acute myelogenous leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, and solid tumors. All patients underwent stem cell collection until a target or a minimum CD34+ cell dose was reached. Correlations were performed between stem cell mobilization and/or collection efficacy and transplantation outcomes.
In general, both larger reinfused CD34+ cell dose and shorter number of days for the stem cell count to reach the minimum of 2 x 10(6) per kg CD34+ cells do not foster quicker engraftment. Reinfused CD34+ cell dose of less than 12 x 10(6) and number of days stem cell collection to reach this minimum CD34+ cell dose did not independently affect the overall survival (OS) or disease-free survival (DFS).
The effectiveness of hematopoietic stem cell mobilization and collection as defined as number of days to reach a CD34+ cell dose of 2 x 10(6) per kg should not be used independently to forecast posttransplantation prognosis, engraftment, DFS, and OS.
造血干细胞的成功动员和采集取决于多种临床因素,如既往化疗和疾病分期。这项回顾性研究的目的是确定动员和采集的有效性是否是自体干细胞移植结果的独立预后因素。
2003年1月至2004年12月期间,共有358例接受移植的患者(201例男性和157例女性患者,年龄2.7至77.3岁,中位年龄53岁)在接受粒细胞集落刺激因子(G-CSF)或G-CSF加化疗预处理后进行了自体造血干细胞采集。这项回顾性研究纳入了诊断为急性髓性白血病、非霍奇金淋巴瘤、霍奇金病、多发性骨髓瘤和实体瘤的患者。所有患者均进行干细胞采集,直至达到目标或最低CD34+细胞剂量。对干细胞动员和/或采集效果与移植结果之间进行了相关性分析。
一般来说,回输的CD34+细胞剂量越大以及干细胞计数达到每千克2×10⁶个CD34+细胞的最低值所需的天数越短,并不会促进更快的植入。回输的CD34+细胞剂量小于12×10⁶ ,以及干细胞采集达到该最低CD34+细胞剂量所需的天数,并未独立影响总生存期(OS)或无病生存期(DFS)。
以达到每千克2×10⁶个CD34+细胞剂量所需天数定义的造血干细胞动员和采集的有效性,不应单独用于预测移植后的预后、植入、DFS和OS。