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Autografting

Recovery from neutropenia can be predicted by the immature reticulocyte fraction several days before neutrophil recovery in autologous stem cell transplant recipients

Bone Marrow Transplantation volume 37, pages 403–409 (2006)Cite this article

Abstract

The duration of neutropenia (absolute neutrophil count (ANC) ⩽100/μl) identifies cancer patients at risk for infection. A test that precedes ANC⩾100/μl would be of clinical value. The immature reticulocyte fraction (IRF) reflects erythroid engraftment and hence a recovering marrow. We evaluated the IRF as predictor of marrow recovery among 90 myeloma patients undergoing their first and second (75 patients) melphalan-based autologous stem cell transplantation (Mel-ASCT). The time to IRF doubling (IRF-D) preceded ANC⩾100/μl in 99% of patients after the first Mel-ASCT by (mean±s.d.) 4.23±1.96 days and in 97% of the patients after the second Mel-ASCT by 4.11±1.95 days. We validated these findings in a group of 117 myeloma patients and 99 patients with various disorders undergoing ASCT with different conditioning regimens. We also compared the time to hypophosphatemia and to absolute monocyte count⩾100/μl to the time to ANC⩾100/μl. These markers were reached prior to this ANC end point in 55 and 25% of patients but were almost always preceded by IRF-D. We conclude that the IRF-D is a simple, inexpensive and widely available test that can predict marrow recovery several days before ANC⩾100/μl.

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Authors and Affiliations

  1. Myeloma Institute of Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    M L Grazziutti, L Dong, M H Miceli, S G Krishna, A Fassas, F van Rhee, B M Barlogie & E J Anaissie

  2. Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    M Cottler-Fox

Authors
  1. M L Grazziutti
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  2. L Dong
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  3. M H Miceli
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  4. M Cottler-Fox
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  5. S G Krishna
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  6. A Fassas
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  7. F van Rhee
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  8. B M Barlogie
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  9. E J Anaissie
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Corresponding author

Correspondence to E J Anaissie.

Additional information

Preliminary results of this manuscript have been presented in abstract form at the 43rd Annual meeting of the Infectious Disease Society of America. San Francisco, October 6–9, 2005

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Grazziutti, M., Dong, L., Miceli, M. et al. Recovery from neutropenia can be predicted by the immature reticulocyte fraction several days before neutrophil recovery in autologous stem cell transplant recipients. Bone Marrow Transplant 37, 403–409 (2006). https://doi.org/10.1038/sj.bmt.1705251

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