A low CD34+ cell dose predicts relapse and death early following autologous blood stem cell transplantation

D. A. Stewart, D. Guo, J. Luider, I. Auer, J. Klassen, D. Morris, A. Chaudhry, C. Brown, S. Glück, J. A. Russell

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

The purpose of this study was to determine if the CD34+ cell dose is independently associated with progression-free (PFS) and overall survival (OAS) for patients treated with autologous blood stem cell transplantation (ASCT). From 1993 to 1999, 277 consecutive patients received ASCT in Calgary for stage 2/3 breast cancer (n = 65), metastatic breast cancer (n = 33), aggressive non-Hodgkin's lymphoma (NHL n = 80), low grade NHL (n = 21), Hodgkin's disease (n = 31), or other cancers (n = 47). Disease status at ASCT was first remission (n = 123), relapse (n = 112), or refractory (n = 42). Patients were grouped into quartiles according to the CD34+ cell dose (<4, 4-7, 7-14, and > 14 × 10 6/kg). Univariate and multivariate analyses were performed for both PFS and OAS considering the following factors: age, gender, diagnosis, disease status (first remission, relapse, refractory), number of prior chemotherapy regimens, prior radiotherapy (RT), mobilization regimen (G-CSF only, Chemotherapy plus G-CSF, or dose-intensive cyclophosphamide, etoposide, cisplatin (DICEP) plus G-CSF), TBI or non-TBI conditioning, and CD34+ cell dose. The most discriminating cut point of the CD34+ dose for PFS (p <.0001, r 2 = .064) and OAS (p <.0001, r 2 = .066) was found to be 4 × 10 6/kg. There was no difference in PFS or OAS between the three quartiles above 4 × 10 6/kg. Using Cox proportional hazards models, factors independently associated with PFS were CD34+ dose <4 × 10 6/kg (RR = 2.21, p <.0001), refractory disease status (RR = 6.03, p <.0001), relapsed disease status (RR = 2.04, p = .002), and age >50 years (RR = 1.91, p = .002). Factors independently associated with OAS were CD34+ dose <4×10 6/kg (RR = 2.14, p = .0007), refractory disease status (RR = 5.35, p <.0001), relapsed disease status (RR = 2.23, p = .0033), and age >50 years (RR = 1.81, p = .012). In conclusion, a CD34+ cell dose less than 4×10 6/kg independently predicted lower PFS and OAS rates following ASCT.

Original languageEnglish (US)
Pages (from-to)19-27
Number of pages9
JournalHematology
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • CD34+ dose
  • Hematopoietic stem cell transplantation
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Hematology

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    Stewart, D. A., Guo, D., Luider, J., Auer, I., Klassen, J., Morris, D., Chaudhry, A., Brown, C., Glück, S., & Russell, J. A. (2001). A low CD34+ cell dose predicts relapse and death early following autologous blood stem cell transplantation. Hematology, 6(1), 19-27. https://doi.org/10.1080/10245332.2001.11746549