International Journal of Hematology

, 74:214

CD34+-Selected Autologous Peripheral Blood Stem Cell Transplantation Conditioned With Total Body Irradiation for Malignant Lymphoma: Increased Risk of Infectious Complications

Authors

  • Satoko Maeda
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Yoshitoyo Kagami
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Michinori Ogura
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Hirofumi Taji
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Ritsuro Suzuki
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Eisei Kondo
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Shouji Asakura
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
  • Takahiro Takeuchi
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
    • Second Department of Internal MedicineNagoya City University School of Medicine
  • Kazuhisa Miura
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
    • Second Department of Internal MedicineNagoya City University School of Medicine
  • Manabu Ando
    • Department of Clinical LaboratoryAichi Cancer Center Hospital
  • Shigeo Nakamura
    • Department of Pathology and GeneticsAichi Cancer Center Hospital
  • Tatsuya Ito
    • First Department of Internal MedicineNagoya University School of Medicine
  • Tomohiro Kinoshita
    • First Department of Internal MedicineNagoya University School of Medicine
  • Ryuzo Ueda
    • Second Department of Internal MedicineNagoya City University School of Medicine
    • Department of Hematology and ChemotherapyAichi Cancer Center Hospital
Case Report

DOI: 10.1007/BF02982008

Cite this article as:
Maeda, S., Kagami, Y., Ogura, M. et al. Int J Hematol (2001) 74: 214. doi:10.1007/BF02982008

Abstract

Although high-dose chemotherapy with autologous peripheral blood stem cell transplantation (autoPBSCT) has been shown or confirmed to be an effective treatment for high-risk and relapsed non-Hodgkin’s lymphoma (NHL), relapse after autoPBSCT remains a serious problem. In a clinical trial to overcome relapse, we adopted a treatment plan in which PBSCs purified in vitro to CD34+ cells to deplete tumor cells (CD34+ autoPBSCT), total body irradiation (TBI) of 1200 cGy, and melphalan, 180 mg/m2, were used as a preconditioning regimen. Eighteen patients with relapsed or high-risk NHL participated in the study. This study compared the incidence of complications following CD34+ autoPBSCT preconditioned with the TBI regimen (n = 10): the TBI group; CD34+ autoPBSCT with the non-TBI regimen (n = 8): the non-TBI group; and unselected autoPBSCT with the non-TBI regimen (n = 19): the unselected autoPBSCT control group.After day 30 posttransplantation, 6 of 10 patients treated with the TBI regimen developed 11 infectious complications in total, compared with only 1 of 8 patients treated with the non-TBI regimen and 4 of 19 patients given unselected autoPBSCT.Two fatal complications occurred in the TBI group, but none occurred in the other 2 groups. The CD4+ lymphocyte count at 1 month posttransplantation was significantly lower in the TBI group than in the unse-lected autoPBSCT group.These findings suggest that the addition of TBI to the preconditioning regimen for CD34+ autoPBSCT is associated with an increased incidence of severe infectious complications after transplantation.

Key words

CD34+ cellAutologous peripheral blood stem cell transplantationLymphomaTotal body irradiationOpportunistic infection

Copyright information

© The Japanese Society of Hematology 2001