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Abstract

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
Authors/Creators:	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
Journal or Publication Title:	European Journal of Haematology
Publisher:	BLACKWELL PUBLISHING,
ISSN:	0902-4441
DOI / ID Number:	https://doi.org/10.1111/j.0902-4441.2006.t01-1-EJH2895.x
Additional Information:	The definitive version is available at www.blackwell-synergy.com
Item Statistics:	View statistics for this item

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