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  • 1
    ISSN: 1432-0584
    Keywords: Key words PBPC autografting ; Apheresis results ; Hematopoietic recovery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  One hundred and nine patients suffering from various malignancies underwent 285 apheresis procedures for PBPC collection. A median of two leukaphereses (range: 2–5) resulted in median numbers of 4.6×108 MNC/kg, 14.1×104 CFU-GM/kg, and 6.0×106 CD34+ cells/kg. Preleukapheresis peripheral blood CD34+ cells correlated significantly with collected CD34+ cells/kg (r=0.94;p〈0.0001) and with CFU-GM/kg (r=0.52;p〈0.0001). A value 〉4×104 CD34+ cells/ml was highly predictive for a collection yield 〉2.5×106 CD34+ cells/kg harvested by a single leukapheresis. Sixty patients were evaluated for hematologic reconstitution and engrafted in a median time of 10 days for WBC 〉1.0×109/l (range: 7–21 days), 10 days for ANC 〉0.5×109/l (7–20) and 11 days for PLT 〉20×109/l (7–62). Reinfused CD34+ cells/kg correlated significantly with hematologic engraftment (r=0.44–0.52 and p〈0.006–0.001) as well as CFU-GM/kg (r=0.36–0.44 and p〈0.007–0.001). A progenitor cell dose 〉2.5×106 CD34+ cells/kg or 〉8.0×104 CFUGM/kg led to a significantly faster recovery for WBC, ANC, and PLT when compared with patients receiving 〈2.5×106 CD34+ cells/kg or 〈8.0×104 CFU-GM/kg. We conclude that rapid hematopoietic engraftment after high-dose therapy and PBPC reinfusion correlates well with a progenitor cell dose 〉2.5×106 CD34+ cells/kg or 〉8.0×104 CFU-GM/kg, and that above a preleukapheresis threshold of 4×104 CD34+ cells/ml a PBPC autograft containing 〉2.5×106 CD34+ cells/kg can be collected by a single leukapheresis. We suggest that patients recovering from myelosuppression should be monitored for CD34+ cells in serial blood samples to determine the course of circulating hematopoietic progenitor cells. This issue will help to define the optimal time point to start apheresis and to predict a PBPC autograft harvested by a single leukapheresis, which will lead to rapid and stable hematopoietic reconstitution following transplantation.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Aplastic anaemia ; Knochenmarktransplantation ; Aplastische Anämie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Rahmen der Arbeitsgemeinschaft Knochenmarktransplantation — München (AG-KMT) wurden vom März 1975 bis Mai 1980 insgesamt 12 Patienten wegen schwerer, aplastischer Anämie mit Knochenmarktransplantation (KMT) behandelt. Sechs Patienten überleben derzeit mit normalem Blutbild und Knochenmark zwischen 10 Monaten und mehr als 5 Jahren nach KMT von HLA-identischen Geschwistern, eine Patientin steht noch in ambulanter Behandlung wegen lokalisierter, chronischer Graft-versus-Host Krankheit (GvHK), fünf Patienten sind klinisch gesund. Sechs Patienten starben, ein Patient starb am Tag vor KMT mit Hirnblutung, drei Patienten 32, 40 und 55 Tage nach KMT an den Folgen der Transplantatabstoßung, einer an schwerer GvHK 85 Tage nach KMT und einer 87 Tage nach KMT vermutlich an interstitieller Pneumonie nach Hirnblutung. Drei von 6 Patienten, die nur mit Cyclophosphamid (CY) vorbehandelt waren, starben infolge Abstoßung des Transplantates. Zwei erwachsene Patienten, die mit CY und „total lymphoid irradiation“ vorbehandelt waren, und drei Kinder, die nach KMT unbestrahlte Leukocytenkonzentrate von Knochenmarkspender erhalten hatten, stießen das Transplantat nicht ab. Die Ergebnisse der AG-KMT sind vergleichbar denen großer, spezialisierter Zentren für KMT und zeigen die Möglichkeiten einer Heilung schwerer aplastischer Anämien durch KMT von HLA-identischen Geschwistern. Die Erfolge sind besser bei frühzeitiger KMT.
    Notes: Summary From March 1975 until May 1980 twelve patients with severe aplastic anemia were grafted with bone marrow from HLA-identical siblings by the Munich Cooperative Group for Bone Marrow Transplantation. Six patients are alive between 10 months and more than 5 years after grafting with normal blood values and marrow. One patient is treated as an out patient for chronic localized graft-versus-host disease (GvHD), five patients are well and without treatment. Six patients have died, one patient with a cerebral hemorrhage the day before transplantation, three patients following rejection of grafts 32, 40 and 55 days after grafting, one patient with severe GvHD 85 days after grafting and one patient, probably with interstitial pneumonia, following cerebral hemorrhage. Three of 6 patients who were conditioned with Cyclophosphamide (CY) only died following rejection of the graft. Two adults who were conditioned with CY and “total lymphoid irradiation” and three children, who were given unirradiated leukocyte concentrates from the marrow donor after grafting, did not reject their grafts. The results of the Munich-Cooperative Group for Bone Marrow Transplantation are comparable to those of large, specialized centers for bone marrow transplantation, they indicate possibilities of cure of severe aplastic anemia by marrow grafts from HLA-identical siblings. They confirm that better results are obtained with earlier transplantation in the course of the disease.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0584
    Keywords: PBPC autografting ; Apheresis results ; Hematopoietic recovery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One hundred and nine patients suffering from various malignancies underwent 285 apheresis procedures for PBPC collection. A median of two leukaphereses (range: 2–5) resulted in median numbers of 4.6×108 MNC/kg, 14.1×104 CFU-GM/kg, and 6.0×106 CD34+ cells/kg. Preleukapheresis peripheral blood CD34+ cells correlated significantly with collected CD34+ cells/kg (r=0.94;p〈0.0001) and with CFU-GM/kg (r=0.52;p〈0.0001). A value 〉4×104 CD34+ cells/ml was highly predictive for a collection yield 〉2.5×106 CD34+ cells/kg harvested by a single leukapheresis. Sixty patients were evaluated for hematologic reconstitution and engrafted in a median time of 10 days for WBC 〉1.0×109/l (range: 7–21 days), 10 days for ANC 〉0.5×109/l (7–20) and 11 days for PLT 〉20×109/l (7–62). Reinfused CD34+ cells/kg correlated significantly with hematologic engraftment (r=0.44–0.52 andp〈0.006–0.001) as well as CFU-GM/ kg (r=0.36–0.44 andp〈0.007–0.001). A progenitor cell dose 〉2.5×106 CD34+ cells/kg or 〉8.0×104 CFU-GM/kg led to a significantly faster recovery for WBC, ANC, and PLT when compared with patients receiving 〈2.5×106 CD34+ cells/kg or 〈 8.0×104 CFU-GM/kg. We conclude that rapid hematopoietic engraftment after high-dose therapy and PBPC reinfusion correlates well with a progenitor cell dose 〉2.5×106 CD34+ cells/kg or 〉8.0×104 CFU-GM/kg, and that above a preleukapheresis threshold of 4×104 CD34+ cells/ml a PBPC autograft containing 〉2.5×106 CD34+ cells/kg can be collected by a single leukapheresis. We suggest that patients recovering from myelosuppression should be monitored for CD34+ cells in serial blood samples to determine the course of circulating hematopoietic progenitor cells. This issue will help to define the optimal time point to start apheresis and to predict a PBPC autograft harvested by a single leukapheresis, which will lead to rapid and stable hematopoietic reconstitution following transplantation.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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