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autologous blood and marrow transplantation - Blog Science ...

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496 Chapter 9: Long-Term Effects<br />

Table 2. Treatment with adjusted-dose mafosfamide (n=98)<br />

Fraction of patients engrafted<br />

PMN Platelets<br />

30 days 60 days 6 months 12 months P value<br />

Higher mafosfamide dose 51 ±7 85 ±5 71 ±7 71 ±7 0.05<br />

Lower mafosfamide dose 71 ±7 95 ± 3 92 ± 4 96 + 3 0.003<br />

Table 3. Factors favorably influencing engraftment: multivariate analyses<br />

Engraftment of neutrophils Engraftment of platelets<br />

Factor P RR P RR<br />

ALL 0.012 1.7 (1.12-2.63) 0.0002 2.12(1.42-3.22)<br />

Dose of <strong>marrow</strong> treated 0.0009 1.91 (1.3-2.8) 0.05 1.43(1-2.05)<br />

Mafosfamide dose adjustment NS 0.003 1.6(1.1-2.3)<br />

Good cryopreservation efficiency 0.014 1.6(1.1-2.3) NS<br />

Table 4, ASCT for acute leukemia (CTU Paris, St. Antoine): kinetics of engraftment<br />

Population PMN recovery (days) Platelet recovery (days)<br />

Global 27 (10-153) 63 (15-1054)<br />

AML 39 (15-766) 70(18-1054)<br />

ALL 20(13-136) 29(10-153)<br />

Prognostic classification<br />

Engraftment of neutrophils. Initial diagnosis, dose of <strong>marrow</strong> prepurging <strong>and</strong><br />

cryopreservation efficiency defined three groups: a good-risk group with fast<br />

engraftment (100% engraftment probability at 30 days), a poor-risk group with<br />

slow/delayed engraftment (37 ± 7%), <strong>and</strong> an intermediate group (67 ± 5%).<br />

The good-risk group consisted of patients fulfilling the following three criteria:<br />

a diagnosis of ALL, a higher stem cell dose prepurging, <strong>and</strong> good cryopreservation.<br />

The poor-risk group included patients with AML <strong>and</strong> a lower stem cell dose. The<br />

intermediate group combined AML patients receiving higher <strong>marrow</strong> doses <strong>and</strong><br />

ALL patients not fulfilling the three criteria that included them in the st<strong>and</strong>ard-risk<br />

group.<br />

Engraftment of platelets. Initial diagnosis, dose of <strong>marrow</strong> prepurging, <strong>and</strong> the<br />

mafosfamide technique used defined three groups: a good-risk group with fast

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