Failure to achieve a threshold dose of CD34+ CD110+ progenitor cells in the graft predicts delayed platelet engraftment after autologous stem cell transplantation

Bone Marrow Transplant. 2007 Nov;40(9):851-7. doi: 10.1038/sj.bmt.1705818. Epub 2007 Aug 20.

Abstract

In this study, we retrospectively analysed the utility of CD110 expression on CD34(+) cells as a predictor of delayed platelet transfusion independence in 39 patients who underwent autologous peripheral blood stem cell transplantation. Absolute CD34(+) cells and CD34(+) subsets expressing CD110 were enumerated using flow cytometry. Of the 39 patients, 7 required 21 days or more to achieve platelet transfusion independence. Six of the seven patients received a dose of CD34(+)CD110(+) cells below 6.0 x 10(4)/kg while 30 of 32 patients who achieved platelet transfusion independence in <21 days received a dose of CD34(+)CD110(+) cells >6.0 x 10(4)/kg (P<0.001). Patients with delayed platelet engraftment received a median dose of 5.2 x 10(4) CD34(+)CD110(+) cells/kg compared with a median dose of 16.4 x 10(4) cells/kg for those engrafting within 21 days (P=0.003). Further analysis showed that >6.0 x 10(4) CD34(+)CD110(+) cells/kg was highly sensitive (93.8%) and highly specific (85.7%) for achieving platelet transfusion independence within 21 days. Delay in platelet transfusion independence translated into an increased requirement for platelet transfusion (median 6 vs 2 transfusions, P<0.0001). The dose of CD34(+)/CD110(+) cells/kg infused at time of transplantation appears to be an important factor identifying patients at risk of delayed platelet engraftment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD34*
  • Blood Platelets / physiology*
  • Cell Count
  • Child
  • Child, Preschool
  • Delayed Graft Function*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cells / cytology*
  • Humans
  • Immunophenotyping
  • Middle Aged
  • Platelet Count
  • Platelet Transfusion
  • ROC Curve
  • Receptors, Thrombopoietin*
  • Retrospective Studies
  • Transplantation, Autologous

Substances

  • Antigens, CD34
  • Receptors, Thrombopoietin