Hematopoietic reconstitution after high-dose chemotherapy and autologous nonfrozen bone marrow rescue

The kinetics of marrow engraftment were analyzed in 50 patients with acute leukemia (21), malignant lymphoma (15), and solid tumors (14) after high-dose multiagent chemotherapy followed by autologous bone marrow transplantation (ABMT) with nonfrozen bone marrow. Unseparated heparinized whole bone marrow was stored in 10% CPDA1 at 4 degrees C for 72 h, then filtered and reinfused. The median number of nucleated cells reinfused was 1.6 x 10(8)/kg (range 0.5-3.8 x 10(8)/kg). All patients had a full hematopoietic reconstitution. Median time to achieve a neutrophil count greater than 500/microliters was 20 days (range 12-39) and median time to achieve an unsupported platelet count greater than 20,000/microliters was 20 days (range 10-55). The main factor associated with delayed engraftment was the number of prior chemotherapy cycles. We conclude that high-dose chemotherapy with nonfrozen ABMT is a safe procedure, without the requirement for costly cryopreservation facilities.