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Factors that predict delayed platelet recovery after autologous stem cell transplantation for lymphoma or myeloma

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Abstract

The amount of infused CD34+ cells has been reported to be the strongest predictor of platelet recovery after autologous stem cell transplantation (ASCT). However, the timing of platelet recovery varies widely among patients even after the infusion of similar amounts of CD34+ cells. Therefore, we retrospectively assessed 99 patients who underwent their first ASCT for lymphoma or myeloma at our center. Thirteen patients (13%) did not achieve platelet engraftment, defined as a platelet count of at least 2.0 × 104/μL without transfusion, at day 28 after transplantation, whereas 58 of 60 patients (97%) who received at least 2.0 × 106/kg CD34+ cells achieved platelet engraftment within 28 days. Multivariate analysis identified the following significant risk factors for delayed platelet recovery: hemoglobin level and platelet count before stem cell harvest, body temperature of > 39 °C within 5 days after ASCT, and infusion of a small amount (< 2.0 × 106/kg) of CD34+ cells. In a subgroup analysis of 39 patients infused with < 2.0 × 106/kg CD34+ cells, a need for repeated apheresis for stem cell harvest and a body temperature of > 39 °C within 5 days after ASCT were identified as independent factors for delayed platelet recovery. In summary, platelet recovery following ASCT was affected by insufficient hematopoietic recovery at stem cell harvest, a need for repeated apheresis, and high fever early after ASCT, particularly when the amount of infused stem cells was insufficient.

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Abbreviations

ASCT:

Autologous stem cell transplantation

G-CSF:

Granulocyte colony-stimulation factor (G-CSF)

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Takashi Nagayama, Masahiro Ashizawa, Takashi Ikeda, Shin-ichiro Kawaguchi, Yumiko Toda, Shoko Ito, Shin-ichi Ochi, Kiyomi Mashima, Kento Umino, Daisuke Minakata, Hirofumi Nakano, Ryoko Yamasaki, Kaoru Morita, Yasufumi Kawasaki, Chihiro Yamamoto, Shin-ichiro Fujiwara, Kaoru Hatano, Kazuya Sato, Iekuni Oh, Ken Ohmine, Kazuo Muroi & Yoshinobu Kanda

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  1. Takashi Nagayama
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  2. Masahiro Ashizawa
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Correspondence to Yoshinobu Kanda.

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Nagayama, T., Ashizawa, M., Ikeda, T. et al. Factors that predict delayed platelet recovery after autologous stem cell transplantation for lymphoma or myeloma. Ann Hematol 99, 2893–2901 (2020). https://doi.org/10.1007/s00277-020-04112-4

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  • DOI: https://doi.org/10.1007/s00277-020-04112-4

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