Enhancing CD34+ Cell Mobilization and Engraftment after Autologous Hematopoietic Stem Cell Transplantation via Adjustment of Granulocyte Colony-Stimulating Factor Dose and Period, a Single Center Experience.

Background & Objective: Insufficient mobilization of hematopoietic stem cells and delayed engraftment are reported in autologous hematopoietic stem cell transplantation (AHSCT). The aim if this study was to identify and introduce predictive factors for mobilization and engraftment. Materials & Metho...

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Publicado en:Journal of Advances in Medical & Biomedical Research Vol. 31; no. 148; pp. 488 - 499
Autores principales: Rafiee, Mohammad, Bonakchi, Hossein, Pordanjani, Sajjad Rahimi, Shahrokhi, Seyedeh Zahra, Mohagheghi, Sina, Farsani, Mehdi Allahbakhshian, Mohammadi, Mohammad Hossein
Formato: research tables/charts Journal Article
Publicado: Zanjan University of Medical Sciences & Health Services Sep/Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Enhancing CD34+ Cell Mobilization and Engraftment after Autologous Hematopoietic Stem Cell Transplantation via Adjustment of Granulocyte Colony-Stimulating Factor Dose and Period, a Single Center Experience.
      aug:
        au:
          Rafiee, Mohammad
          Bonakchi, Hossein
          Pordanjani, Sajjad Rahimi
          Shahrokhi, Seyedeh Zahra
          Mohagheghi, Sina
          Farsani, Mehdi Allahbakhshian
          Mohammadi, Mohammad Hossein
        affil: Dept. of Medical Laboratory Sciences, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran.
      sug:
        subj:
          Hematopoietic Stem Cell Transplantation
          Autografts
          Granulocyte Colony-Stimulating Factor Administration and Dosage
          Human
          Blood Component Removal
          Flow Cytometry
          Univariate Statistics
          Multivariate Analysis
          ROC Curve
          Predictive Value of Tests
          Descriptive Statistics
          Iran
          Cox Proportional Hazards Model
          Data Analysis Software
          Male
          Female
          Adult
          Middle Age
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background & Objective: Insufficient mobilization of hematopoietic stem cells and delayed engraftment are reported in autologous hematopoietic stem cell transplantation (AHSCT). The aim if this study was to identify and introduce predictive factors for mobilization and engraftment. Materials & Methods: The participants include AHSCT candidates. Pre-apheresis CD34+ cells and CD34+ count per kilogram (CD34+ CPK) in the apheresis products were assessed by flow cytometry. There were other parameters connected to platelet and neutrophil engraftment as well as mobilization by granulocyte-stimulating growth factor (G-CSF). Univariate, multivariate, and receiver operating characteristic (ROC) analyses were used in the statistical study. Results: The predictive value of CD34+ CPK for platelet engraftment was fair (AUC: 76.9%) with the cut-off of 3.5×106 , while it was poor for neutrophil engraftment (AUC: 64.4%) with the cut-off of 3.4×106. The multiple-variate analysis demonstrated that age and CD34+ CPK were positively correlated with platelet engraftment (pvalues less than 0.01 and 0.005, respectively), while CD34+ CPK and total dose of infused G-CSF (TDIG) were associated with neutrophil engraftment (p-values: 0.03). In high rates, the TDIG correlated negatively with CD34+ CPK, CD34+ cell counts in pre-apheresis peripheral blood samples, and total engraftment, indicating negative effects of high and long-term doses of G-CSF on mobilization and engraftment. Conclusion: The management of AHSCT will be more efficient by considering the age, CD34+ CPK, and TDIG. For enhanced engraftment, adjusting the G-CSF injection days for <4 days and total dose of G-CSF on <4000 micrograms are suggested.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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