Analysis of platelet recovery after autologous transplantation with G-CSF mobilized CD34+ cells purified from leukapheresis products

• Published in: Hematology and cell therapy 1997-12, Vol.39 (6), p.317-325
• Main Authors: Hermouet, S, Niaussat, A E, Briec, A, Pineau, D, Robillard, N, Bataille, R, Milpied, N, Harousseau, J L, Mahé, B
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antigens, CD34 - analysis; Blood Cell Count; Blood Platelets - cytology; Blood Transfusion, Autologous; Colony-Forming Units Assay; Erythroid Precursor Cells - cytology; Female; Granulocyte Colony-Stimulating Factor - pharmacology; Hematopoietic Stem Cell Mobilization; Hematopoietic Stem Cell Transplantation; Hematopoietic Stem Cells - chemistry; Hematopoietic Stem Cells - immunology; Humans; Leukapheresis; Lymphoma, Follicular - blood; Male; Middle Aged; Multiple Myeloma - blood; Neutrophils - cytology; Thrombocytopenia - blood; Thrombocytopenia - etiology; Time Factors
• ISSN: 1269-3286; 1279-8509
• DOI: 10.1007/s00282-997-0317-8

We studied platelet recovery in relation to graft content in CFUs and CD34+ cells in 31 patients with multiple myeloma (21) or non-Hodgkin lymphoma (10) receiving marrow-ablative therapy followed by autologous transplantation with G-CSF mobilized CD34+ cells purified from leukapheresis products. Twelve patients had prolonged post-transplantation thrombopenia (> or = 14 days): their graft contents in CD34+ cells, CFU-GM and BFU-E were significantly inferior to those of patients with rapid platelet recovery. Although numbers of infused CD34+ cells and CFU-GM or BFU-E were well correlated, the graft content in CD34+ cells was the only parameter predictive of platelet recovery (r = -0.38, p = 0.04), with a threshold of 2.5 x 10(6) CD34+ cells/kg. However, because rapid platelet reconstitution was obtained for 4 of 16 patients re-infused with < 2.5 x 10(6) CD34+ cells/kg, we investigated whether the graft CFU-MK content might be a better predictor of platelet reconstitution than the CD34+ cell content. Eighteen CD34 grafts were studied for CFU-MK content: CD34 and CFU-MK contents were weakly correlated (r = 0.52, p = 0.03), but there was no correlation between numbers of infused CFU-MK and time to platelet recovery. We conclude that, for autologous CD34 grafts, CFU-MK assays, like CFU-GM or BFU-E assays, cannot be used to predict platelet recovery. A CD34+ cell content > or = 2.5 x 10(6)/kg remains the only reliable indicator of the platelet reconstitution capacity of a CD34 graft.