FACTORS INFLUENCING HEMATOPOIETIC RECOVERY FOLLOWING CHEMOTHERAPY-MOBILIZED AUTOLOGOUS PERIPHERAL-BLOOD PROGENITOR-CELL TRANSPLANTATION FORHEMATOLOGICAL MALIGNANCIES - A RETROSPECTIVE ANALYSIS OF A 10-YEAR SINGLE INSTITUTION EXPERIENCE

We retrospectively analysed the factors that influenced rate of haemop oietic recovery (HR) in 243 patients after transplantation with chemot herapy-mobilised autologous peripheral blood progenitor cells (PBPC), Approximately half the patients also received haemopoietic growth fact ors (HGF) for mobilisation, Conditioning for transplantation was with either chemotherapy alone or chemotherapy plus total body irradiation (TBI), Median time to recovery of granulocytes greater than or equal t o 0.5 x 10(9)/l was 13 days (range 7-93 days) and of platelets greater than or equal to 50 x 10(9)/l 14 days (7-440), Speed of HR was greate r, both for neutrophils and platelets for patients who received more r ather than less CFU-GM than our median value of 18.9 x 10(4)/kg (P < 0 .0001 in both instances) and more rather than less CD34-positive cells than our median value of 8.8 x 10(6)/kg (P<0.0001 and P<0.0005, respe ctively). For granulocyte recovery, in the multivariate analysis the d ose of infused CFU-GM (P = 0.05) and the use of HGF for both mobilisat ion and posttransplantation (P < 0.0014) were significant positive fac tors. For platelet recovery in the multivariate analysis the dose of i nfused CFU-GM (P < 0.0016) was a positive factor. The use of busulphan and of TBI were significant adverse factors for rate of platelet reco very (P=0.005 and 0.0004, respectively). When compared with non-HGF-mo bilised PBPC, HGF-mobilised PBPC reduced the number of days of hospita lisation (28 vs 24, P=0.0001) and of treatment with intravenous antibi otics (15 vs 11, P = 0.0004), These findings emphasise the importance of cell dose in accelerating haemopoietic recovery after autologous bl ood stem cell transplantation.