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Adequate Engraftment With Lower Hematopoietic Stem Cell Dose.

Preethi Jeyaraman¹, Pronamee Borah¹, Nitin Dayal²

¹Division of Hematology and Bone Marrow Transplantation, Max Super-specialty Hospital, Saket, New Delhi, India.

Clinical Lymphoma, Myeloma & Leukemia

|February 6, 2020

Summary

Autologous stem cell transplantation (ASCT) can be safely performed with lower hematopoietic stem cell doses in a noncryopreserved setting. This study found similar engraftment times and no increased infection risk in patients receiving reduced stem cell doses.

Keywords:

ASCT Infection Lymphoma Myeloma Noncryopreserved

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Area of Science:

Hematology
Oncology
Stem Cell Transplantation

Background:

Autologous stem cell transplantation (ASCT) traditionally requires adequate hematopoietic stem cell (HSC) doses.
The precise minimum HSC dose for successful ASCT remains an area of investigation.

Purpose of the Study:

To evaluate the safety and efficacy of ASCT using lower HSC doses in a noncryopreserved setting.
To compare engraftment kinetics, infection rates, and transplant-related mortality between patients receiving different HSC doses.

Main Methods:

Retrospective analysis of 108 patients with multiple myeloma and lymphoma undergoing ASCT with noncryopreserved stem cells.
Patients were stratified into two groups based on stem cell dose: < 2 × 10^6/kg and higher doses.
Comparison of neutrophil and platelet engraftment, hospital stay, infection incidence, and mortality.

Main Results:

Neutrophil engraftment was similar (12 vs. 11 days, P=0.065) and platelet engraftment was comparable (12 vs. 11 days, P=0.017) between groups.
Hospital stay and incidence of proven bacterial infections were similar across both dose groups.
No transplant-related mortality was observed in the lower HSC dose group.

Conclusions:

ASCT can be safely performed with reduced HSC doses when stem cells are not cryopreserved.
Lower HSC doses do not appear to compromise engraftment or increase infectious complications in this noncryopreserved setting.
These findings suggest flexibility in HSC dose requirements for ASCT in noncryopreserved protocols.