ISSN: 1300-7777 E-ISSN: 1308-5263
Does Reinfusion of Stem Cell Products on Multiple Days Affect Engraftment? [Turk J Hematol]
Turk J Hematol. Ahead of Print: TJH-58897 | DOI: 10.4274/tjh.2018.0071  

Does Reinfusion of Stem Cell Products on Multiple Days Affect Engraftment?

Serife Solmaz Medeni1, Dogus Turkyılmaz2, Celal Acar1, Omur Gokmen Sevindik3, Faize Yuksel2, Ozden Piskin2, Mehmet Ali Ozcan2, Fatih Demirkan2, Bulent Undar2, Inci Alacacioglu2, Hayri Guner Ozsan2
1S.B.U. Izmir Bozyaka Education and Research Hospital, Hematology, Izmir, Turkey
2Dokuz Eylul Universıty Faculty of Medicine Hematology, zmir, Turkey
3Fırat Universıty Faculty of Medicine Hematology, Elazig, Turkey

Introduction: High dose melphalan chemotherapy and autologous stem cell transplantation in multiple myeloma ( MM ) is still important treatment modality in transplant eligible patients. At least 2 x 106 /kg CD 34+ cell dose is preferred for sufficient engraftment. Some patients need multiple leukapheresis procedures to reach a required number of the CD34+ cell but this can cause high volume of stem cell product that can not be given in a single day.
Aim: Whether the number of infusion days affect engraftment or not, isn’t studied before. We want to evaluate the effect of reinfusion of stem cell in multiple day on engraftment results. Demographic features, CD 34+ cell doses, neutrophil and platelet engraftment days, hospitalization days, number of infusion days of 149 autologous transplantation of 143 multiple myeloma patients were evaluated retrospectively.
Results: The data of 143 multiple myeloma patients who were transplanted were analyzed retrospectively. Median age was 55 ± 8,5 (26-70) with 91/58 Male/Female ( M/F) ratio. The hospitalization day for all patients was 24 ± 6 (14-50) day. Mean CD 34+ cell number was 7,5 ±5,3 x 106/kg(1,5-31 x 106/kg). CD34+ cells were reinfused in one day in 80,5% (n: 120) of the patients, 2 days in 18,2% of the patients (n: 27) and3 days in 1,3% of patients (n: 2). For 29 patients, reinfusion was performed in more than one day because of the high volume of stem cell product. We didn’t see any dimethyl sulfoxide toxicity, cardiac arrhythmia and volume overload complication. Hypertensive attack during infusion was easily controlled by frusemide infusion. In multiple infusions group, the infused CD34+ cell numbers were mean 4,8 ± 2,8x106/kg and in single infusion group, the infused CD34+ cell numbers were mean 8,1 x106/kg ± 5,5 x106/kg. There were no statistical differences between two groups regarding to platelet and neutrophil engraftment days ( p= 0.85 and p= 0.5 ). There was no statistical difference between two groups for the hospitalization days ( p=0.06).
Conclusion: In cases with high volume stem cell product to obtain sufficient stem cell, reinfusion can be safely applied over several days without any delay in engraftment.

Keywords: Multiple myeloma, autologous transplantation, multiple reinfusion day.

Corresponding Author: Serife Solmaz Medeni

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