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Effect of CD34 cell dose on hematopoietic reconstitution and outcome in 508 patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation


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Klaus, J and Fruehauf, S and Moehler, T and Ho, AD and Goldschmidt, H and Herrmann, D and Breitkreutz, I and Hegenbart, U and Mazitschek, U and Egerer, G and Cremer, FW and Lowenthal, RM and Huesing, J (2007) Effect of CD34 cell dose on hematopoietic reconstitution and outcome in 508 patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. European Journal of Haematology, 78 (1). pp. 21-28. ISSN 0902-4441

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Background: We analyzed the hematopoietic reconstitution and outcome of 508 patients with multiple
myeloma (MM) with respect to the number of CD34+ cells reinfused at our center. Patients and methods:
Each cohort of 390 patients (unselected CD34+ cell transplant) and 118 patients (CD34+ selected transplant)
was divided into four subgroups. Among the 390 transplantations, 86 patients received a high dose
(HD)) of ‡6.50 · 106 unselected CD34+ cells/kg, 116 patients a low dose (LD)) of <3.00 · 106 CD34+
cells/kg. Among the patients treated with CD34+ selected PBSC, 34 received ‡6.50 · 106 CD34+ cells/kg
(HD+) and 16 <3.00 · 106 CD34+ cells/kg (LD+). Results: HD) patients experienced a reduced median
time to leukocyte (13 d vs. 14 d) (P < 0.001) and platelet reconstitution >20 · 109/L (10 d vs. 12 d)
(P < 0.001). Similarly, HD+ showed a reduced median time to leukocyte (12 d vs. 15 d) (P < 0.001) and
platelet recovery >20 · 109/L (10 d vs. 11 d) (P = 0.058). CD34+ cell-dose was significant for long-term
platelet recovery at day 360 (unselected transplant P = 0.015, selected transplant P = 0.023). Number of
transplanted CD34+ cells had no significant impact on transplant related mortality, overall survival or CR/PR
rates within 100 d. In terms of supportive care the differences of high-/low-dose grafts were minimal.
Conclusions: These results confirm that high doses of CD34+ PBSC shorten hematopoietic reconstitution
and reduce hospitalization. Nevertheless secure engraftment results from transplantation of 2.00–
3.00 · 106 CD34+ cells/kg. As 60% of our pretreated patients are able to collect ‡5.00 · 106 CD34+ cells/
kg within a single leukapheresis, division into two or more freezing bags allows safe tandem transplantation
in the majority of MM patients.

Item Type: Article
Journal or Publication Title: European Journal of Haematology
Page Range: pp. 21-28
ISSN: 0902-4441
Identification Number - DOI: 10.1111/j.0902-4441.2006.t01-1-EJH2895.x
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Date Deposited: 07 Apr 2008 14:05
Last Modified: 18 Nov 2014 03:33
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