الملخص الإنجليزي
Objectives: Autologous peripheral blood stem cells transplantation (APBSCT) is a
therapeutic option which can be used in various hematological, neoplastic disorders
including lymphoproliferative disease (LPD). Differences in patient populations and
treatment modalities in different transplant centers mean it is important to improve
the knowledge of the different factors affecting engraftment after APBSCT for the
success of this procedure. We sought to determine the factors influencing neutrophil
and platelet engraftment after APBSCT in patients with LPD. Methods: We conducted
a retrospective review of 70 patients with LPD (35 with lymphoma and 35 with multiple
myeloma) who had undergone APBSCT between January 2008 and December 2016.
Data obtained included disease type, treatment, and stem cell characteristics. KaplanMeier analysis was performed for probabilities of neutrophil and platelet engraftment
occurred and was compared by the log-rank test. The multivariate Cox proportional
hazards regression model was used for the analysis of potential independent factors
influencing engraftment. A p-value < 0.050 was considered statistically significant.
Results: Most patients were ethnic Malay, the median age at transplantation was 49.5
years. Neutrophil and platelet engraftment occurred in a median time of 18 (range 4–65)
and 17 (range 6–66) days, respectively. The majority of patients showed engraftment with
65 (92.9%) and 63 (90.0%) showing neutrophil and platelet engraftment, respectively.
We observed significant differences between neutrophil engraftment and patient's weight
(< 60/≥ 60 kg), stage of disease at diagnosis, number of previous chemotherapy cycles
(< 8/≥ 8), and pre-transplant radiotherapy. While for platelet engraftment, we found
significant differences with gender, patient's weight (< 60/≥ 60 kg), pre-transplant
radiotherapy, and CD34+ dosage (< 5.0/≥ 5.0 × 106
/kg and < 7.0/≥ 7.0 × 106
/kg).
The stage of disease at diagnosis (p = 0.012) and pre-transplant radiotherapy (p = 0.025)
were found to be independent factors for neutrophil engraftment whereas patient's
weight (< 60/≥ 60 kg, p = 0.017), age at transplantation (< 50/≥ 50 years, p = 0.038),
and CD34+ dosage (< 7.0/≥ 7.0 × 106
/kg, p = 0.002) were found to be independent
factors for platelet engraftment. Conclusions: Patients with LPD who presented at an
early stage and with no history of radiotherapy had faster neutrophil engraftment after
APBSCT, while a younger age at transplantation with a higher dose of CD34+ cells may
predict faster platelet engraftment. However, additional studies are necessary for better
understanding of engraftment kinetics to improve the success of APBSCT.
