The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 1
Initial white blood cell kinetics for assessment of individual response to the conditioning regimen in pediatric hematopoietic stem cell transplantation patients
Divisions of 1Pediatric Bone Marrow Transplantation, 2Social Pediatrics, and 4Pediatric Hematology, 3Department
of Pediatrics, and 5Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
E-mail: duckan@hacettepe.edu.tr
We hypothesized that the individual hematological response to chemo/
radiotherapy may be used as a parameter to assess the degree of myeloablation
and probability of transplant-related events. This study included 58 pediatric
patients who underwent allogeneic hematopoietic stem cell transplantation
(HSCT). White blood cell (WBC) ratio (pre-conditioning WBC: day 0 WBC),
day 0 WBC count, and WBC nadir day were used as potential indicators of
myeloablation. The association between WBC kinetics and clinical result of
HSCT was investigated. There was a positive correlation between WBC ratio
and the date of engraftment. A positive correlation was noted between day 0
WBC count and engraftment day. There was a negative correlation between
WBC nadir day and engraftment day. WBC nadir day was lower in patients
with acute graft-versus-host disease (GVHD) than in cases without acute
GVHD. Among patients who had fever during the conditioning regimen, the
WBC ratio was higher, day 0 WBC count was lower, and WBC nadir day was
lower in patients who developed >5 days of fever between day 0 and day
+30. The present preliminary study suggests that WBC kinetics may be used
as a measure of initial hematological response to the conditioning regimen
and perhaps in determining the degree of myeloablation.
Keywords :
white blood cell kinetics, children, hematopoietic stem cell transplantation.