Ovlivňuje kvalita štěpu a aplikace filgrastimurekonstituci krvetvorby a výsledky autologníchtransplantací krvetvorných kmenových buněku nemocných s maligními lymfomy?

Skoumalová I., Pikalová Z., Zapletalová J., Indrák K.:Do a quality of graft and application of filgrastim affect reconstitution of haemopoiesisand outcomes of autologous stem cell transplantation in malign lymphoma patients?

Retrospective analysis of 105 patients who underwent high-dose chemotherapy BEAM followingautologous stem cell transplantation because of Hodgkin´s (29) or non-Hodgkin´s lymfoma (76) demonstratedassociation 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 associationwith 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 maysuggest, in accordance with some reports, significant increase of CD34+ cells over 5,0x106/kg in graftalready does not significantly shorten the interval of severe cytopenia. After haematopoietic progenitorcells riched graft transfers, administration of filgrastim probably more than proliferation potentiatestheir maturation to granulocytes, obviously to the detriment of megakaryocytopoiesis with slowingdown platelet normalization. Higher count of transferred bags and increased risk of death associationcorrespond 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.