Predictive factors for engraftment kinetics of autologous hematopoietic stem cells in children.

Abstract

Background: Engraftment after hematopoietic stem cell transplantation is the recovery rate of neutrophils and platelets. This study aimed to test the impact of the patient's general characteristics, pre-transplantation factors, and quality parameters of hematopietic stem cell products on hematopietic recovery and to define predictive factors for engraftment in children.

Methods: This retrospective study included 52 patients aged from 1 to 18 years old treated with autologous transplantation at the Mother and Child Health Care Institute of Serbia "Dr. Vukan Čupić" in Belgrade, from January 2013 until December 2018. Data were collected from medical records and apheresis procedure protocols. SPSS 20.0 software package was used for statistical data processing.

Results: The median neutrophil engraftment was 18.0 (16.0-22.5) days, while the median platelet engraftment was 11.0 (10.0-18.0) days. Statistically significant correlations were found between neutrophil engraftment and patient's age (p-value = 0.050), body weight (p-value = 0.021), diagnosis (p-value = 0.023), source of stem cells (p-value = 0.001), and the number of CFU-GM/kg (p-value = 0.018). A statistically significant correlation was found between platelet engraftment and the time from diagnosis to the transplantation (p-value = 0.043), source of stem cells (p-value = 0.009), and the number of CD34⁺ cells/kg (p-value = 0.014).

Conclusions: Predictive factors for hematopoietic recovery in this study were the patient's age, body weight, diagnosis, time from diagnosis to hematopoietic stem cell transplantation, source of hematopietic stem cells, the number of CD34⁺ cells/kg, and the number of CFU-GM/kg.