Toxicities after peripheral blood progenitor cell transplantation for lymphoid malignancies: analysis of 300 cases in a single institution

Bone Marrow Transplant. 1999 Jun;23(12):1309-15. doi: 10.1038/sj.bmt.1701820.

Abstract

Two hundred and seventy-seven consecutive patients with non-Hodgkin's lymphoma (n = 207), Hodgkin's disease (n = 27) and multiple myeloma (n = 43) were intensified from October 1989 until April 1997 and received unmanipulated PBPC transplants. Twenty-three patients received a double intensification, out of a total of 300 PBPC transplantations analyzed. Conditioning regimens consisted of total body irradiation (TBI)-containing regimens (n = 141), BEAM (n = 104), high-dose melphalan (n = 26), ICE (n = 23) or other regimens (n = 6). Eighty-four percent of the patients (119/142) evaluable for long-term hematological reconstitution beyond 180 days achieved normal trilineage blood counts. Abnormal hematological parameters were associated with low numbers of CD34+ cells re-infused and with prior exposure to fludarabine. The 100-day and long-term treatment-related mortality rates were 4% and 4%, respectively. Late complications and treatment-related toxicities were influenced by disease history, use of TBI and exposure to fludarabine. Patients older than 60 years did not have greater toxicities or more frequent treatment-related deaths. This analysis suggests that while leading to a limited morbidity and a low mortality rate, intensive chemotherapy with PBPC transplantation still remains a procedure leading to significant short- and long-term toxicities. Better recognition of the risk factors associated with these complications might allow a further decrease in their incidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD34
  • Female
  • Hematopoiesis
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hodgkin Disease / therapy*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Middle Aged
  • Multiple Myeloma / therapy*
  • Retrospective Studies
  • Survival Rate
  • Transplantation Conditioning
  • Vidarabine / adverse effects
  • Vidarabine / analogs & derivatives
  • Whole-Body Irradiation

Substances

  • Antigens, CD34
  • Immunosuppressive Agents
  • Vidarabine
  • fludarabine