Document Detail


Failure of trilineage blood cell reconstitution after initial neutrophil engraftment in patients undergoing allogeneic hematopoietic cell transplantation - frequency and outcomes.
MedLine Citation:
PMID:  14755315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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/microl or red blood cell transfusion independence/reticulocyte count >/=1.0% by day 60) or subsequent (n=21, ANC <500/microl for >/=3 days, platelet <20 000/microl 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.
Authors:
K-H Lee; J-H Lee; S-J Choi; J-H Lee; S Kim; M Seol; Y-S Lee; W-K Kim; J-S Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  33     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-22     Completed Date:  2004-10-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  729-34     Citation Subset:  IM    
Affiliation:
Section of Hematology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. khlee2@amc.seoul.kr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Cells / physiology
Cell Lineage
Chi-Square Distribution
Female
Graft Rejection / blood,  pathology
Graft vs Host Disease
Hematologic Neoplasms / mortality,  therapy
Hematopoiesis
Hematopoietic Stem Cell Transplantation / adverse effects*,  mortality
Humans
Male
Middle Aged
Neutrophils / physiology
Pancytopenia
Retrospective Studies
Transplantation, Homologous
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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