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ctt-journal > Chernyavskaya T.1 et al. (Abstract)

Chernyavskaya T.1 et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract37

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

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Application of autologous stimulated bone marrow as a source of hematopoietic material for transplantation

Tatiana Z. Chernyavskaya, Sergey N. Abdusalamov, Ludmila U. Grivtsova, Kapitolina N. Melkova, Nikolay N. Tupitsyn

N.N. Blokhin Cancer Research Center, RAMS, Moscow, Russia

Correspondence: Tatiana Z. Chernyavskaya, N.N. Blokhin Cancer Research Center, 23, Kashirskoe sh., Moscow, Russia, E-mail:  9067552930@spam is badmail.ru

Abstract

Autologous hematopoietic stem cell (HSC) transplantation allows an increase in the intensity of chemotherapy. However, several factors limit its widespread use, one of which is the failure of quality transplant harvesting. This study was initiated to develop tactics for obtaining an adequate number of HSC in different groups of patients.

Between August 2006 and June 2011 autologous bone marrow (autoBM) harvesting was performed in 81 patients (44 women, 37 men, median age 28 y., range 16–67) with HD (58), acute leukemia (14), NHL (7), and solid tumors (2). In 70 cases G-CSF (10–24 mkg/kg/day) stimulated bone marrow (sBM) was harvested. The indications for autoBM harvesting were the need for HSC grafts for 2 courses of high-dose chemotherapy (HDC) for lymphoma (n=31), prior PBSC collection failure (n=16), a high probability of PBSC collection failure in refractory HD (n=20) and the need to consolidate the first remission in acute leukemia (n=12). A minimum level of 1х108 nuclear cells (NC)/kg was considered as sufficient for transplantation. The median NC number was 2.78 x108/kg (range 0.47 to 6.77). Two bone marrow grafts (2.5%) contained less than 1 x108/kg NC and were regarded as unsuccessful. The median number of CD34 + cells and granulocyte-macrophage colony forming units (GM CFU) were 1.87x106/kg (0.4–7) and 7.2 x104/kg (4.8–13.2) respectively.

We compared the post-transplant period between sBM and PBSC transplant groups using pair methods. Each group included 21 transplantations in patients with refractory HD. In the PBSC group a median transplanted CD34+ cell number was 3 x106/kg (range 2.1 to 14.3). The neutrophil (above 0.5x109/l) and platelet (above 50 x 109/l) recovery occurred at the D+11 (range 9–15) and D+12 (range 10–19) respectively. In the sBM group both neutrophil (D+18, range, 11–33) and platelet  (D+19, range, 11–50) recovery was later. A higher need for platelet transfusion (median, 4 doses, range 1–14 vs. 2, range 0–4) and red blood cells (median, 5 doses, range 1–8 versus 2, range 0–5) was in the sBM group. There was no correlation between the CD4+ lymphocyte recovery and infectious complications in the post-transplant period. The frequency of infectious and life-threatening complications was not significantly different in the analyzed groups. Post-transplant mortality was not observed in either group.

Thus, we can note that autoBM is an acceptable alternative HSC source for patients with PBSC collection failure, in AL patients and in cases with repeated autoBMT. The use of sBM comparison with PBSC transplantation is not accompanied by an increased mortality and serious post-transplantation complications.

Keywords: source of hematopoietic cells, stimulated bone marrow