Singh V, Krishnamurthy J, Duffey S, Meagher R, Villa M, Monreal J, Evens A, Frankfurt O, Altman J, Gordon L, Tallman M, Williams S, Winter J, Singhal S, Mehta J
Department of Hematology/Oncology, Northwestern University Medical School, 676 North St Clair Street, Chicago, IL 60611, USA.
Bone Marrow Transplant. 2009 Feb;43(4):301-5. doi: 10.1038/bmt.2008.322. Epub 2008 Oct 6.
CD34+ cell dose calculations are usually based on actual body weight (ABW). We have shown that ideal body weight (IBW) may provide a better basis for this in a small population of patients with hematologic malignancies. This was studied further in 514 myeloma autografts. The CD34+ cell doses (10(6)/kg) by IBW and ABW were 1.37-39.36 (median 6.03) and 1.15-29.67 (median 4.84), respectively. IBW-based cell doses correlated slightly better with engraftment than ABW-based doses (higher r(2)): 0.5 x 10(9)/l neutrophils 0.83 versus 0.82, 1.0 x 10(9)/l neutrophils 0.78 versus 0.77, 20 x 10(9)/l platelets 0.54 versus 0.53 and 50 x 10(9)/l platelets 0.57 versus 0.55. When outliers (hematologic recovery in <8 or >16 days) were excluded, the findings were similar: 0.5 x 10(9)/l neutrophils 0.85 versus 0.84, 1.0 x 10(9)/l neutrophils 0.85 versus 0.84, 20 x 10(9)/l platelets 0.86 versus 0.85 and 50 x 10(9)/l platelets 0.85 versus 0.84. CD34+ cell doses based on IBW as well as ABW significantly affected engraftment when analyzed separately as continuous variables. However, when analyzed together, only the dose based on IBW retained significance. We conclude that calculation of CD34+ cell numbers for autotransplantation should be based on IBW.
CD34+细胞剂量计算通常基于实际体重（ABW）。我们已经表明，对于一小部分血液系统恶性肿瘤患者，理想体重（IBW）可能为此提供更好的依据。在514例骨髓瘤自体移植中对此进行了进一步研究。基于IBW和ABW的CD34+细胞剂量（10⁶/kg）分别为1.37 - 39.36（中位数6.03）和1.15 - 29.67（中位数4.84）。基于IBW的细胞剂量与植入的相关性略优于基于ABW的剂量（r²更高）：中性粒细胞达到0.5×10⁹/L时分别为0.83和0.82，中性粒细胞达到1.0×10⁹/L时分别为0.78和0.77，血小板达到20×10⁹/L时分别为0.54和0.53，血小板达到五十×10⁹/L时分别为0.57和0.55。当排除异常值（血液学恢复在8天内或超过16天）时，结果相似：中性粒细胞达到0.5×10⁹/L时分别为0.85和0.84，中性粒细胞达到1.0×10⁹/L时分别为0.85和0.84，血小板达到20×10⁹/L时分别为0.86和0.85，血小板达到五十×10⁹/L时分别为0.85和0.84。当作为连续变量单独分析时，基于IBW以及ABW的CD34+细胞剂量均显著影响植入。然而，当一起分析时，只有基于IBW的剂量具有显著性。我们得出结论，自体移植的CD34+细胞数量计算应基于IBW。
