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Effects of spleen status on early outcomes after hematopoietic cell transplantation. Bone Marrow Transplant 2013 Jun;48(6):825-31 PMID: 23222382 PMCID: PMC3606905

Pubmed ID

23222382

DOI

10.1038/bmt.2012.249

Abstract

To assess the impact of spleen status on engraftment, and early morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT), we analyzed 9,683 myeloablative allograft recipients from 1990 to 2006; 472 had prior splenectomy (SP), 300 splenic irradiation (SI), 1,471 with splenomegaly (SM), and 7,440 with normal spleen (NS). Median times to neutrophil engraftment (NE) and platelet engraftment (PE) were 15 vs 18 days and 22 vs 24 days for the SP and NS groups, respectively (P<0.001). Hematopoietic recovery at day +100 was not different across all groups, however the odds ratio of days +14 and +21 NE and day +28 PE were 3.26, 2.25 and 1.28 for SP, and 0.56, 0.55, and 0.82 for SM groups compared to NS (P<0.001), respectively. Among patients with SM, use of peripheral blood grafts improved NE at day +21, and CD34+ cell dose >5.7 × 10(6)/kg improved PE at day+28. After adjusting variables by Cox regression, the incidence of GVHD and OS were not different among groups. SM is associated with delayed engraftment, whereas SP prior to HCT facilitates early engraftment without having an impact on survival.

Author List

Akpek G, Pasquini MC, Logan B, Agovi MA, Lazarus HM, Marks DI, Bornhaeüser M, Ringdén O, Maziarz RT, Gupta V, Popat U, Maharaj D, Bolwell BJ, Rizzo JD, Ballen KK, Cooke KR, McCarthy PL, Ho VT

Authors

Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Associate Professor in the Medicine department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Ctr Associate Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-84879072722   21 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Allografts
Disease-Free Survival
Female
Follow-Up Studies
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Retrospective Studies
Spleen
Splenectomy
Survival Rate
Time Factors
jenkins-FCD Prod-331 a335b1a6d1e9c32173c9534e6f6ff51494143916