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[Factors influencing engraftment in hematological patients after human leukocyte antigen matched sibling allogeneic blood and marrow transplantation].

OBJECTIVE
To investigate the factors influencing engraftment in patients with hematological diseases after human leukocyte antigen matched sibling allogeneic blood and marrow transplantation.


METHODS
One hundred and fifty-seven patients with hematological diseases who underwent allogeneic blood and marrow transplantation were enrolled in this study. The cell compositions in allografts were determined using multi-color flow cytometry.


RESULTS
The median time for the engraftment of neutrophil and platelet was 15 (11-25) days and 12 (7-78) days, respectively. Univariate analyses demonstrated that the source of allografts (P = 0.049) and allograft-infused cell doses of CD34+ cells (P = 0.001) was correlated with neutrophil engraftment. The duration from diagnosis to transplantation (P = 0.043) and allograft-infused cell doses of CD cells (P < 0.001) were correlated with platelet engraftment. Multivariate analysis showed that allograft-infused cell doses of CD34+ cells were associated with a rapid neutrophil recovery (RR: 1.222, 95% CI: 1.063-1.405, P = 0.005) and platelet reconstitution (RR: 1.228, 95% CI: 1.090-1.382, P = 0. 001), the duration from diagnosis to transplantation was associated with platelet recovery (RR: 1.000, 95% CI: 0.999-1.000, P = 0.065). A significantly faster recovery of neutrophils (14.5 d) and platelets (11 d) was found in patients infused > 2.45 x 10(6)/kg CD34+ cells as compared with those (16 d and 14 d) infused < or = 2.45 x 10(6)/kg CD34+ cells (P = 0.021, 0.010, respectively).


CONCLUSION
The absolute number of CD34+ cell in allografts was a main factor influencing the engraftment of neutrophil and platelet after HLA-matched sibling allogeneic blood and marrow transplantation. Duration from diagnosis to transplantation was another factor influencing engraftment of platelet.