Research Article
Comparison of Single Day Versus Two and Three Day Fractionated Infusion of Peripheral Stem Cells in Autologous Transplantation
Abstract
Bacgroun/Purpose: The aim of this study was to investigate the safety, difference in duration of engraftment and relapse rates between autologous transplant patients who had their stem cell infusions during a single day or multiple days.
Methods: In this retrospective study the clinical data of 77 ASCT patients from a single center,30 of whom were transplanted in fractionated infusions were investigated. Duration of engraftment, side effects during the transplant, PFS and OS data of the two groups was compared.
Results: There was no statistical difference between single day and fractionated infusion patients regarding neutrophil engraftment, toxic side effects, PFS, OS and relapse rate at 18 months. Platelet engraftment was delayed for one day in the fractionated group, which did not cause prolonged hospitalization. The transplant patients who had multiple day infusion had similar engraftment duration despite their lower average CD34+ cell counts.
Conclusion: Fractionated infusions lead to similar engraftment duration to single day infusion for ASCT. The higher CFU cell number seen in the poorly mobilized patients may have a key role in the adequate engraftment. The fractionated infusion approach for such patients was feasible, safe and no increase of the disease relapse was observed with this procedure.
Keywords
References
- 1.Weaver CH, Hazelton B, Birch R, et al. An analysis of engraftment kinetics as a function of the CD34 content of peripheral blood progenitor cell collections in 692 patients after the administration of myeloablative chemotherapy. Blood. 1995; 86: 3961-3969.
- 2. Dreger P, Kloss M, Petersen B, et al. Autologous progenitor cell transplantation: prior exposure to stem cell-toxic drugs determines yield and engraftment of peripheral blood progenitor cell but not of bone marrow grafts. Blood. 1995; 86:3970-3978.
- 3. Iskra Pusic, Shi Yuan Jiang, Scott Landua, et al. Impact of Mobilization and Remobilization Strategies on Achieving Sufficient Stem Cell Yields for Autologous Transplantation, Biology of Blood and Marrow Transplantation.2008;14:1045-1056
- 4. Bensinger W, Appelbaum F, Rowley S, et al: Factors That Influence Collection and Engraftment of Autologous Peripheral-Blood Stem Cells. J Clin Oncol. 1995; 13:2547-2555
- 5 Stiff PJ, Koester AR, Weidner MK, et al: Autologous bone marrow transplantation using unfractionated cells cryopreserved in dimethylsulfoxide and hydroxyethyl starch without controlled-rate freezing. Blood 1987;70:974-978
- 6. Haas R, Möhle R, Frtihauf S, et al: Patient characteristics associated with successful mobilizing and autografting of peripheral blood progenitor cells in malignant lymphoma. Blood 1994; 83:3787-3794
- 7. Sharp JG, Vaughan WP, Kessinger A et al. Significance of detection of tumor cells in hematopoietic stem cell harvests of patients with breast cancer. In: Dicke KA, Armitage JO, Dicke-Evenger MJ (eds). Autologous Bone Marrow Transplantation Proceedings of the Fifth International Symposium. The University of Nebraska Medical Center: Omaha, 1991; pp 385–391.
- 8.Solano C, Badia B, Lluch A et al. Prognostic significance of the immunocytochemical detection of contaminating tumor cells (CTC) in apheresis products of patients with high-risk breast cancer treated with high-dose chemotherapy and stem cell transplantation. Bone Marrow Transplant 2001; 27: 287–293.
- 9.Stadtmauer EA, Tsai DE, Sickles CJ et al. Stem cell transplantation for metastatic breast cancer: analysis of tumor contamination. Med Oncol.1999; 16: 279–288.
- 10.O Donnell JR, Burnett AK, Sheehan T et al. Safety of dimethylsulfoxide. Lancet. 1981;1:498
- 11. Davis JM, Rowely SD, Braine HG, et al. Clinical toxicity of cryopreserved bone marrow graft infusion. Blood. 1990; 75:781-6
- 12. K Kiel, FW Cremer, C Rottenburger et al. Analysis of circulating tumor cells in patients with multiple myeloma during the course of high-dose therapy with peripheral blood stem cell transplantation. Bone Marrow Transplantation. 1999; 23: 1019–1027
- 13 Rowley SD. Hematopoietic stem cell cryopreservation. In:Thomas ED, Blume KG, Forman SJ, eds. Hematopoietic cell transplantation.Malden: Blackwell Science,1999:481-492
- 14. Galmes A, Besalduch J, Bargay J, et al. Cryopreservation of hematopoietic progenitor cells with 5- percent dimethyl sulfoxide at -80 degress C without rate controlled freezing. Transfusion. 1996; 36:794-797 15 Martino M, Morabito F, Messina G et al. Fractionated Infusions Of Cryopreserved Stem Cells May Prevent DMSO-Induced Major Cardiac Complicatıons In Graft Recipients. Haematologica. 1996; 81:59-61
- 16. M A Gertz , R C Wolf , Ivana N et al. Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma Bone Marrow Transplantation. 2010; 45:1396–1403; doi:10.1038/bmt.2009.370
- 17 Boiron JM, Dazey B, Cailliot C, et al. Large-scale expansion and transplantation of CD34(+) hematopoietic cells: in vitro and in vivo confirmation of neutropenia abrogation related to the expansion process without impairment of the long-term engraftment capacity. Transfusion. 2006; 46: 1934-42
Year 2024,
Volume: 15 Issue: 3, 212 - 219, 01.07.2024
Abstract
References
- 1.Weaver CH, Hazelton B, Birch R, et al. An analysis of engraftment kinetics as a function of the CD34 content of peripheral blood progenitor cell collections in 692 patients after the administration of myeloablative chemotherapy. Blood. 1995; 86: 3961-3969.
- 2. Dreger P, Kloss M, Petersen B, et al. Autologous progenitor cell transplantation: prior exposure to stem cell-toxic drugs determines yield and engraftment of peripheral blood progenitor cell but not of bone marrow grafts. Blood. 1995; 86:3970-3978.
- 3. Iskra Pusic, Shi Yuan Jiang, Scott Landua, et al. Impact of Mobilization and Remobilization Strategies on Achieving Sufficient Stem Cell Yields for Autologous Transplantation, Biology of Blood and Marrow Transplantation.2008;14:1045-1056
- 4. Bensinger W, Appelbaum F, Rowley S, et al: Factors That Influence Collection and Engraftment of Autologous Peripheral-Blood Stem Cells. J Clin Oncol. 1995; 13:2547-2555
- 5 Stiff PJ, Koester AR, Weidner MK, et al: Autologous bone marrow transplantation using unfractionated cells cryopreserved in dimethylsulfoxide and hydroxyethyl starch without controlled-rate freezing. Blood 1987;70:974-978
- 6. Haas R, Möhle R, Frtihauf S, et al: Patient characteristics associated with successful mobilizing and autografting of peripheral blood progenitor cells in malignant lymphoma. Blood 1994; 83:3787-3794
- 7. Sharp JG, Vaughan WP, Kessinger A et al. Significance of detection of tumor cells in hematopoietic stem cell harvests of patients with breast cancer. In: Dicke KA, Armitage JO, Dicke-Evenger MJ (eds). Autologous Bone Marrow Transplantation Proceedings of the Fifth International Symposium. The University of Nebraska Medical Center: Omaha, 1991; pp 385–391.
- 8.Solano C, Badia B, Lluch A et al. Prognostic significance of the immunocytochemical detection of contaminating tumor cells (CTC) in apheresis products of patients with high-risk breast cancer treated with high-dose chemotherapy and stem cell transplantation. Bone Marrow Transplant 2001; 27: 287–293.
- 9.Stadtmauer EA, Tsai DE, Sickles CJ et al. Stem cell transplantation for metastatic breast cancer: analysis of tumor contamination. Med Oncol.1999; 16: 279–288.
- 10.O Donnell JR, Burnett AK, Sheehan T et al. Safety of dimethylsulfoxide. Lancet. 1981;1:498
- 11. Davis JM, Rowely SD, Braine HG, et al. Clinical toxicity of cryopreserved bone marrow graft infusion. Blood. 1990; 75:781-6
- 12. K Kiel, FW Cremer, C Rottenburger et al. Analysis of circulating tumor cells in patients with multiple myeloma during the course of high-dose therapy with peripheral blood stem cell transplantation. Bone Marrow Transplantation. 1999; 23: 1019–1027
- 13 Rowley SD. Hematopoietic stem cell cryopreservation. In:Thomas ED, Blume KG, Forman SJ, eds. Hematopoietic cell transplantation.Malden: Blackwell Science,1999:481-492
- 14. Galmes A, Besalduch J, Bargay J, et al. Cryopreservation of hematopoietic progenitor cells with 5- percent dimethyl sulfoxide at -80 degress C without rate controlled freezing. Transfusion. 1996; 36:794-797 15 Martino M, Morabito F, Messina G et al. Fractionated Infusions Of Cryopreserved Stem Cells May Prevent DMSO-Induced Major Cardiac Complicatıons In Graft Recipients. Haematologica. 1996; 81:59-61
- 16. M A Gertz , R C Wolf , Ivana N et al. Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma Bone Marrow Transplantation. 2010; 45:1396–1403; doi:10.1038/bmt.2009.370
- 17 Boiron JM, Dazey B, Cailliot C, et al. Large-scale expansion and transplantation of CD34(+) hematopoietic cells: in vitro and in vivo confirmation of neutropenia abrogation related to the expansion process without impairment of the long-term engraftment capacity. Transfusion. 2006; 46: 1934-42
There are 16 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Haematology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | July 1, 2024 |
| Submission Date | March 19, 2024 |
| Acceptance Date | June 20, 2024 |
| Published in Issue | Year 2024Volume: 15 Issue: 3 |
