TITLE

Failure of trilineage blood cell reconstitution after initial neutrophil engraftment in patients undergoing allogeneic hematopoietic cell transplantation - frequency and outcomes

AUTHOR(S)

J-H Lee, L.; S-J Choi, L.; J-H Lee, L.; Y-S Lee, L.; W-K Kim, L.; J-S Lee, L.; K-H Lee, L.; S. Kim; M. Seol, L.

PUB. DATE

April 2004

SOURCE

Bone Marrow Transplantation;Apr2004, Vol. 33 Issue 7, p729

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Summary:The outcomes of patients who experience the failure to reconstitute a trilineage of blood cells after initial neutrophil engraftment were evaluated in 178 patients with hematologic disorders, who underwent allogeneic HCT. Of 165 qualified patients (five with primary engraftment failure; eight deaths before day 60 of HCT), 43 (26%) satisfied the criteria for the initial (n=22; failure of platelet >20?000/�l or red blood cell transfusion independence/reticulocyte count ?1.0% by day 60) or subsequent (n=21, ANC <500/�l for ?3 days, platelet <20?000/�l for ?7 days, or red blood cells transfusion/reticulocyte <1.0% after initial trilineage reconstitution) failure. GVHD was the most common clinical condition associated with cytopenia (n=24). In all, 20 patients (47%) recovered at least partially with a median of 52 days (range 8-323) later, with 12 of those 20 patients recovering completely. The eventual reconstitution failure rate was 14% (23/163 patients). The number of cell lineages involved in the cytopenia was the only independent variable that predicted partial recovery (1 lineage vs 2-3 lineages with odds ratio of 8.69 (95% CI 1.96-38.60), P=0.004). Five/20 patients with vs 20/23 patients without partial recovery died. Trilineage reconstitution failures after allogeneic HCT need systematic analysis in the future studies.Bone Marrow Transplantation (2004) 33, 729-734. doi:10.1038/sj.bmt.1704428 Published online 2 February 2004

ACCESSION #

12598695

Tags: BLOOD -- Diseases;  TRANSPLANTATION of organs, tissues, etc. -- Complications;  NEUTROPHILS -- Therapeutic use;  HEMATOPOIETIC stem cells -- Transplantation;  RETICULOCYTES

 

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