Predictive factors for long-term engraftment of autologous blood stem cells

Data from 170 consecutive patients aged 19-66 years (median age 46 years) who underwent unmanipulated autologous blood stem cell transplant (ASCT) were analyzed to determine if total CD34 + cells/kg infused, CD34 + subsets (CD34 + 41 + , CD34 + 90 + , CD34 + 33 - , CD34 + 38 - , CD34 + 38 - DR - ), peripheral blood CD34 + cell (PBCD34 + ) count on first apheresis day, or various clinical factors were associated with low blood counts 6 months post ASCT. Thirty-four patients were excluded from analysis either because of death (n = 17) or re-induction chemotherapy prior to 6 months post ASCT (n = 13), or because of lack of follow-up data (n = 4). Of the remaining 136 patients, 46% had low WBC (<4 × 10 9 /l), 41% low platelets (<150 x 10 9 /l), and 34% low hemoglobin (<120 g/l) at a median of 6 months following ASCT. By Spearman's rank correlation, both the total CD34 + cell dose/kg and the PBCD34 + count correlated with 6 month blood counts better than any subset of CD34 + cells or any clinical factor. The PBCD34 + count was overall a stronger predictor of 6 month blood counts than was the total CD34 + cells/kg infused. Both factors retained their significance in multivariate analysis, controlling for clinical factors. In conclusion, subsets of CD34 + cells and clinical factors are inferior to the total CD34 + cell dose/kg and PBCD34 + count in predicting 6 month blood counts following ASCT.