Acute Phase Proteins for Monitoring Hematopoietic Recovery After Early Engrafting of CD34+ Peripheral-Blood-Stem-Cells for Autografting or Allografting in Patients with Malignant Diseases.

Annals of transplantation : quarterly of the Polish Transplantation Society

PubMedID: 28555068

Gawronski K, Tomasiuk R, Wcislo G, Rzepecki P, Wajs J. Acute Phase Proteins for Monitoring Hematopoietic Recovery After Early Engrafting of CD34+ Peripheral-Blood-Stem-Cells for Autografting or Allografting in Patients with Malignant Diseases. Ann Transplant. 2017;22323-332.
BACKGROUND
Neutropenic fever (NF) is associated with delayed engraftment after peripheral blood stem cell transplantation (PBSCT).

MATERIAL AND METHODS
We followed the levels of acute-phase proteins (APPs) serially in 60 patients after peripheral blood stem-cell autograft (n=39) or peripheral blood stem-cell allograft (n=21) for hematologic malignancies and germinal tumors; we then examined the correlation of those levels with the presence of fever and with markers of engraftment.

RESULTS
Fever (present in 60% of patients) was associated with a highly statistically significant delay in reaching conventional engraftment targets (ANC >500/µL [0.5×10^9/L]; platelets >20,000/µL [20×10^9/L]; reticulocytes >20,000/µL [20×10^9/L]) (for all associations, p<0. 001). Every 4th day for 24 days, we measured the APPs levels and the number of neutrophils (ANC), platelets (PL), and reticulocytes (RET) to reach the reference values of >0. 5 G/L or >1. 0 G/L for ANC, >20 G/L or >50 G/L for PL, and >20 G/L for RET, respectively. The presence of NF resulted in longer time to engraft hematopoietic stem cells with ANC, PL, and PET counts statistically significant (range 0. 001-0. 004). The median day range for NF patients was 21. 22-26. 89 versus 13. 88-19. 13 for no NF patients.

CONCLUSIONS
Our results provide additional information for monitoring hematopoietic engraftment in patients following PBSCT; the presence of NF can be tracked by serial measurements in serum of three investigated APPs throughout an early phase of hematopoietic recovery.