CD34(+)-selected autologous peripheral blood stem cell transplantation conditioned with total body irradiation for malignant lymphoma: Increased riskof infectious complications

Citation
S. Maeda et al., CD34(+)-selected autologous peripheral blood stem cell transplantation conditioned with total body irradiation for malignant lymphoma: Increased riskof infectious complications, INT J HEMAT, 74(2), 2001, pp. 214-221
Citations number
37
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
Journal title
INTERNATIONAL JOURNAL OF HEMATOLOGY
ISSN journal
0925-5710 → ACNP
Volume
74
Issue
2
Year of publication
2001
Pages
214 - 221
Database
ISI
SICI code
0925-5710(200108)74:2<214:CAPBSC>2.0.ZU;2-Q
Abstract
Although high-dose chemotherapy with autologous peripheral blood stem cell transplantation (autoPBSCT) has been shown or confirmed to be an effective treatment for high-risk and relapsed non-Hodgkin's lymphoma (NHL), relapse after autoPBSCT remains a serious problem. In a clinical trial to overcome relapse, we adopted a treatment plan in which PBSCs purified in vitro to CD 34(+) cells to deplete tumor cells (CD34(+) autoPBSCT), total body irradiat ion (TBI) of 1200 cGy, and melphalan,180 mg/m(2), were used as a preconditi oning regimen. Eighteen patients with relapsed or high-risk NHL participate d in the study. This study compared the incidence of complications followin g CD34(+) autoPBSCT preconditioned with the TBI regimen (n = 10): the TBI g roup; CD34(+) autoPBSCT with the non-TBI regimen (n = 8): the non-TBI group ; and unselected autoPBSCT with the non-TBI regimen (n = 19): the unselecte d autoPBSCT control group. After day 30 posttransplantation, 6 of 10 patien ts treated with the TBI regimen developed 11 infectious complications in to tal, compared with only 1 of 8 patients treated with the non-TBI regimen an d 4 of 19 patients given unselected autoPBSCT. Two fatal complications occu rred in the TBI group, but none occurred in the other 2 groups. The CD4(+) lymphocyte count at 1 month posttransplantation was significantly lower in the TB I group than in the unselected autoPBSCT group. These findings sugge st that the addition of TBI to the preconditioning regimen for CD34(+) auto PBSCT is associated with an increased incidence of severe infectious compli cations after transplantation. (C) 2001 The Japanese Society of Hematology.