Skoumalová I., Pikalová Z., Zapletalová J., Indrák K.:
Do a quality of graft and application of filgrastim affect reconstitution of haemopoiesis
and outcomes of autologous stem cell transplantation in malign lymphoma patients?
Raida L.1, Faber E.1, Papajík T.1, Skoumalová I.1, Pikalová Z.1, Zapletalová J.2,Indrák K.1
1Hemato-onkologická klinika FN, Olomouc 2Katedra biofyziky LF UP, Olomouc |
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Summary:
Retrospective analysis of 105 patients who underwent high-dose chemotherapy BEAM following
autologous stem cell transplantation because of Hodgkin´s (29) or non-Hodgkin´s lymfoma (76) demonstrated
association between rapidity of platelet engraftment and count of CD34+ cells in the graft.
Increase of neutrophils was significantly accelerated after higher total dose of filgrastim and association
with retarded normalization of platelets was observed on the other hand. Increased risk of death,
mainly by progression of the disease, was associated with higher count of transfused bags. One may
suggest, in accordance with some reports, significant increase of CD34+ cells over 5,0x106/kg in graft
already does not significantly shorten the interval of severe cytopenia. After haematopoietic progenitor
cells riched graft transfers, administration of filgrastim probably more than proliferation potentiates
their maturation to granulocytes, obviously to the detriment of megakaryocytopoiesis with slowing
down platelet normalization. Higher count of transferred bags and increased risk of death association
correspond to difficult stem cells mobilization from refractory, relapsing and often pretreated patients.
Their prognosis is due to lymfoma unfavourable, regardless of transplantation has been performed.
Key words:
autologous transplantation, haematopoietic stem cells, lymfoma, filgrastim, engraftment,
remission, relapse.
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