Bone Marrow Hypocellularity, Decreased Platelet Counts and Colony Forming Units Serve as Prognostics Parameters for Early Complications after Autologous Peripheral Blood Stem Cell Transplantation

High-dose chemotherapy with autologous peripheral blood stem cell transplantation (auto-PBSCT) offers a valid treatment option in cancer patients (pts) with advanced, relapsed or high-risk (HR) disease. Auto-PBSCT is in general a safe procedure, however, some pts may have a dismal outcome due to treatment related mortality (TMR), early relapse (ER) and/or failure of blood cell reconstitution (FBR). Risk factors predisposing for early complications after PBSCT have not yet been clearly assessed. From a total of 796 pts having been transplanted over a 10 year (y) period (6/93-5/03), we determined 50 pts (group A, m:f=29:21), who had primary FBR or died within 3 months after PBSCT. As a control group, 50 pts who had undergone PBSCT over the same period, were randomly selected (group B; m:f=25:25). Pre-PBSCT-parameters associated with early complications were examined by univariate analysis. Median age at transplant was similar in group A (52y) and group B (54y). Group A vs. B had underlying lymphoma in 31 vs. 17, solid tumors in 13 vs. 21 and leukemias in 6 vs. 12 pts, respectively. Notable differences were a lower performance status, more pretreatment chemotherapy (CX)-cycles, higher LDH levels, lower platelet counts, hypocellular bone marrow (BM) and lower colony forming units (CFU) in group A. Treatment before PBSCT in group A consisted of a median number of 7 CX (group B: 4 CX) cycles. Median number of retransfused CD34+-cells were similar (group A 4.1 vs. group B 3.7x10e6/kg bw). Total CFUs/1.5e5, determined by methylcellulose culture of PBSC grafts in group A were considerably decreased with 128 vs. 187 (group B), and BFU-E, CFU-GM, and CFU-GEMM were 51 vs. 79, 55 vs. 87 and 5 vs. 4, respectively. Hypocellular BM was observed in group A and B in 46% vs. 4% of pts (odds ratio 20.44 [p