Predictive factors for long-term engraftment of autologous blood stem cells

Data from 170 consecutive patients aged 19-66 years (median age 46 years) w ho underwent unmanipulated autologous blood stem cell transplant (ASCT) wer e analyzed to determine if total CD34(+) cells/kg infused, CD34(+) subsets (CD34(+)41(+), CD34(+)90(+), CD34(+)33(-), CD34(+)38(-), CD34(+)38(-)DR(-)) , peripheral blood CD34(+) cell (PBCD34(+)) count on first apheresis day, o r various clinical factors were associated with low blood counts 6 months p ost ASCT, Thirty-four patients were excluded from analysis either because o f death (n = 17) or reinduction chemotherapy prior to 6 months post ASCT (n = 13), or because of lack of follow-up data (n = 4), Of the remaining 136 patients, 36% had low WBC (<4 x 10(9)/l), 41% low platelets (<150 x 10(9)/l ), and 34% low hemoglobin (<120 g/l) at a median of 6 months following ASCT , By Spearman's rank correlation, both the total CD34(+) cell dose/kg and t he PBCD34(+) count correlated with 6 month blood counts better than any sub set of CD34(+) cells or any clinical factor. The PBCD34(+) count was overal l a stronger predictor of 6 month blood counts than was the total CD34(+) c ells/kg infused. Both factors retained their significance in multivariate a nalysis, controlling for clinical factors. In conclusion, subsets of CD34() cells and clinical factors are inferior to the total CD34(+) cell dose/kg and PBCD34(+) count in predicting 6 month blood counts following ASCT.