Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Clin Lab Anal. 2021 Dec;35(12):e24060. doi: 10.1002/jcla.24060. Epub 2021 Oct 21.
Hematopoietic stem cell transplantation (HSCT) is one of the treatments for hematologic malignancies. Numerous factors affect the HSCT outcome. The purpose of this study was to investigate the effect of post-HSCT administration of granulocyte colony-stimulating factor (post-G-CSF) on early neutrophil and platelet engraftment in allogeneic HSCT (allo-HSCT).
MATERIAL & METHODS: The study was performed on 76 patients diagnosed with AML and ALL. All patients underwent allo-HSCT at Taleghani stem cell transplantation center, Tehran, Iran, from February 2016 to December 2018. Chemotherapy regimens based on patients' conditions were selected between myeloablative and reduced-intensity regimens.
Statistical analysis revealed that the number of administered G-CSF units after HSCT was a time-dependent variable. Statistical analysis before day +11 reported that patients who received G-CSF <14 units had three times better early neutrophil engraftment than those with G-CSF ≥14 (CI 95%, AHR = 3.03, p:0.002). CD3+ cells count <318.5 × 10 /kg was associated with fast platelet engraftment (CI 95%, AHR 2.28, p:0.01).
In this study, post-G-CSF stimulation was associated with early engraftment in a time- and dose-dependent manner. Administration of G-CSF beyond 14 units resulted in adverse effects on neutrophil early engraftment. It also appeared that with a reduction in CD3+ cell counts, the likelihood of GVHD decreases, and platelet engraftment occurs earlier. Further investigations in the future are required to determine the factors affecting the process of early engraftment.
造血干细胞移植(HSCT)是血液系统恶性肿瘤的治疗方法之一。许多因素会影响 HSCT 结果。本研究旨在探讨 HSCT 后粒细胞集落刺激因子(post-G-CSF)给药对异基因 HSCT(allo-HSCT)中早期中性粒细胞和血小板植入的影响。
该研究纳入了 76 例被诊断为 AML 和 ALL 的患者。所有患者于 2016 年 2 月至 2018 年 12 月在伊朗德黑兰的 Taleghani 干细胞移植中心接受 allo-HSCT。根据患者的情况选择基于化疗的强化疗方案或减量化疗方案。
统计分析表明,HSCT 后给予 G-CSF 的单位数是一个时间依赖性变量。在第+11 天之前的统计分析报告称,接受 G-CSF <14 单位的患者比接受 G-CSF ≥14 单位的患者早期中性粒细胞植入效果好 3 倍(95%CI,AHR = 3.03,p = 0.002)。CD3+细胞计数<318.5×10 /kg 与血小板早期植入有关(95%CI,AHR 2.28,p = 0.01)。
在这项研究中,post-G-CSF 刺激与时间和剂量依赖的早期植入有关。给予超过 14 单位的 G-CSF 会对中性粒细胞早期植入产生不良影响。CD3+细胞计数的减少似乎会降低 GVHD 的发生概率,从而使血小板更早植入。未来需要进一步研究以确定影响早期植入过程的因素。