Clinical Factors Contributing to the Pace of Engraftment After Allogeneic and Autologous Stem Cell Transplantation

Abstract

Previously, we have shown that a number of clinical factors contributed to the pace of recovery of granulocytes (>500/uL) and platelets (>20,000/uL) after high dose therapy when followed by autologous bone marrow transplantation or when followed by autologous peripheral blood cell transplantation (where hematopoietic progenitor cells had been “mobilized” by a variety of regimens). Recently, we evaluated two additional patient populations to determine whether such clinical factors remained important determinants regulating recovery of blood counts after hematopoietic stem cell transplantation. The first population was 164 consecutive recipients of allogeneic, unstimulated, unmanipulated bone marrow from healthy donors. The second population was 276 consecutive recipients of autologous peripheral blood cells collected after mobilization with cyclophosphamide based chemotherapy and granulocyte- colony stimulating factor. Using time dependent, censored data, multivariate analyses, we found a number of clinical factors made significant contributions to engraftment (two tailed values of P < 0.05). After allogeneic bone marrow transplant: 1) for granu- locyte recovery—patient diagnosis, degree of HLA match between donor and patient, high dose regimen, granulocyte-colony stimulating factor use after transplant, and acute