Autologous hematopoietic stem cell transplantation (ASCT) is an established treatment for patients with hematologic malignancies, yet the impact of transplanted CD34 + cell dose on clinical outcomes is unresolved. We conducted post hoc analyses of transplanted CD34 + cell dose and hematopoietic recovery following ASCT in 438 patients with non-Hodgkin lymphoma (NHL) or multiple myeloma (MM), using data from 2 multicenter phase 3 clinical studies that compared plerixafor plus granulocyte-colony stimulating factor (G-CSF) versus placebo plus G-CSF as stem cell mobilization regimens. Days to engraftment and the proportion of patients who reached predetermined blood count thresholds were compared across 3 CD34 + cell dose levels: 2-4 × 10 6 cells/kg, 4-6 × 10 6 cells/kg, and >6 × 10 6 cells/kg, regardless of mobilization treatment. Short-term neutrophil and platelet engraftment times were similar regardless of cell dose. A significant linear trend was observed between transplanted CD34 + cell dose and the proportion of patients with platelet count >150 × 10 9/L at 100 days (P < .001), 6 months (P = 026), and 12 months (P = 020) in patients with NHL, and at 100 days in patients with MM (P = 004). A linear trend was also observed between transplanted cell dose and the proportion of patients with platelet count >100 × 10 9/L at 100 days (P < .001) and 6 months (P = 023) in patients with NHL. A higher cell dose was associated with a lower percentage of NHL patients requiring red blood cell transfusions (P = 006). Our analyses confirm previous findings that transplanted CD34 + cell dose may be associated with better long-term platelet recovery after ASCT.
- Autologous peripheral blood stem cell transplantation
- Cell dose
- Platelet recovery
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