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Prepublished online as a Blood First Edition Paper on August 1, 2002; DOI 10.1182/blood-2002-01-0339. This Article Full Text (PDF) All Versions of this Article: 2002-01-0339v1 100/12/3930    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dominietto, A. Articles by Bacigalupo, A. Search for Related Content PubMed PubMed Citation Articles by Dominietto, A. Articles by Bacigalupo, A. Social Bookmarking                   What's this? Submitted February 5, 2002 Accepted July 10, 2002 Transplant-related mortality and long-term graft function are significantly influenced by cell dose in patients undergoing allogeneic marrow transplantation Alida Dominietto*, Teresa Lamparelli, Anna Maria Raiola, Maria Teresa Van Lint, Francesca Gualandi, Giovanni Berisso, Stefania Bregante, Carmen di Grazia, Monica Soracco, Anna Pitto, Francesco Frassoni, and Andrea Bacigalupo Dipartimento di Ematologia, Ospedale San Martino, Genova, Italy * Corresponding author; email: adominietto{at}smartino.ge.it. We have studied the impact of cell dose on short and long term graft function and outcome in 905 patients undergoing an unmanipulated allogeneic bone marrow transplant (BMT) from an HLA identical sibling (n=735), a one-antigen mismatched related donor (n=35) or a matched unrelated donor (n=135). Median number of nucleated cells infused was 3.4x108/Kg (25th percentile 2.4x108/Kg, 75th percentile 5x108/Kg). Patients were stratified according to cells infused in three groups: <=2.4 x108/Kg (n=247) (low dose), <=5 x108/Kg (n=452) (intermediate dose) and >5x108/Kg (n=206) (high dose). Patients receiving high cell dose had significantly higher platelet counts on days +20, +50, +100, +180, +365 after BMT (p<0.01) and higher white blood cell counts on days +50, +100 and +180 after BMT (p<0.01) as compared to other patients. The actuarial 5 year transplant-related mortality (TRM) was 41% vs 36% vs 28% (p=0.01), overall survival was 45% vs 51% vs 56% (p=0.0008) and disease-free survival was 41% vs 42% vs 48% respectively (p=0.04) in patients receiving low, intermediate or high cell dose. The cell dose effect was more pronounced in patients over 30 years, with advanced disease, with chronic myeloid leukemia and with alternative donors. In multivariate COX analysis on TRM, cell dose was a significant predictor (p=0.002) (relative risk 0.6), together with donor type (p=0.0001), year of transplant (p=0.0001), conditioning regimen (p=0.02), recipient age (p=0.02). In conclusion transplantation of high marrow cell dose is associated with reduced transplant mortality, improved survival and results in improved graft function, both short and long term. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. A. Pulsipher, P. Chitphakdithai, B. R. Logan, S. F. Leitman, P. Anderlini, J. P. Klein, M. M. Horowitz, J. P. Miller, R. J. King, and D. L. Confer Donor, recipient, and transplant characteristics as risk factors after unrelated donor PBSC transplantation: beneficial effects of higher CD34+ cell dose Blood, September 24, 2009; 114(13): 2606 - 2616. [Abstract] [Full Text] [PDF] P. Bader, H. Kreyenberg, G. H.R. Henze, C. Eckert, M. Reising, A. 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