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Japanese Journal of Clinical Oncology 32:135-139 (2002)
© 2002 Foundation for Promotion of Cancer Research

Infusion of a High Number of CD34+ Cells Provides a Rapid Hematopoietic Recovery and Cost Savings in Autologous Peripheral Blood Stem Cell Transplantation

Eishi Ashihara1, Chihiro Shimazaki1, Akira Okano1, Mayumi Hatsuse1, Akio Okamoto1, Kazuho Shimura1, Ryoichi Takahashi1, Toshiya Sumikuma1, Tohru Inaba2, Naohisa Fujita2, Satoshi Murakami3, Harue Haruyama3 and Masao Nakagawa1,+,§

1 Second Department of Medicine and 2 Department of Clinical Laboratory and Medicine, Kyoto Prefectural University of Medicine, Kyoto and 3 Department of Medicine, Shakaihoken Kyoto Hospital, Kyoto, Japan

Background: The objectives of this study were to evaluate the effect of the number of infused CD34+ cells on hematopoietic recovery and on the cost in autologous peripheral blood stem cell transplantation (PBSCT).

Methods: Sixty-nine patients who received autologous PBSCT (ABSCT) were divided into three groups defined by the number of infused CD34+ cells. The number of days until 0.5 x 109/l neutrophils and 50 x 109/l platelets, the number of transfused blood products, the febrile days, the duration of parenteral antibiotics and the cost of additional supportive care (transfusions of blood products and parenteral antibiotics) were analyzed.

Results: Twenty-three patients received <2.5 x 106/kg of CD34+ cells (group A), 25 patients received >=2.5 to 5 x 106/kg of CD34+ cells (group B) and 21 patients received >=5 x 106/kg of CD34+ cells (group C). Patients in group C had rapid neutrophil (p < 0.01) and platelet (p < 0.05) recovery and required less platelet transfusions (p < 0.05) than patients in other groups. Transfusions of red blood cell concentrates, the duration of febrile days or parenteral antibiotics were not statistically different between the two groups. The patients in group C required significantly lower costs for platelet concentrates and additional supportive care (p < 0.05).

Conclusion: Infusion of >=5 x 106/kg of CD34+ cells in ABSCT shortens hematopoietic recovery and reduces costs for additional supportive care.

+ For reprints and all correspondence: Eishi Ashihara, Second Department of Medicine, Kyoto University of Medicine, 465 Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.

§ Abbreviations: PBSCT, peripheral blood stem cell transplantation; ABSCT, autologous PBSCT; BMT, bone marrow transplantation; AML, acute myelogenous leukemia; ALL, acute lymphoblastic leukemia; NHL, non-Hodgkin’s lymphoma; MM, multiple myeloma; HD, Hodgkin’s disease; SCLC, small cell lung cancer; CA, cytarabine; ETP, etoposide; CPM cyclophosphamide; G-CSF, granulocyte colony-stimulating factor; CBDCA, calboplatin; TBI, total body irradiation; CFU-GM, colony-forming unit of granulocyte macrophage; RC-MAP, red blood cell concentrates; PC, platelet concentrates; PIPC, piperacillin sodium; SBT/CPZ, sulbactum sodium/cefoperazon sodium; SE, standard error


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