
Myelosuppression Post RIC SCT/DLI
- Myelosuppression (aplasia) occurs in approximately 35% of relapsed leukaemia patients given unmodified DLI.
- Myelosuppression in this context is defined as a decrease in neutrophils to < 0.5 X 109/L and/or platelet count to < 50 X 109/L.
- If myelosuppression occurs, a bone marrow aspirate and biopsy needs to be performed. Samples should be sent for chimerism analysis by FISH or PCR as appropriate.
Patients with myelosuppression secondary to DLI should be managed as follows:
- G-CSF (5 mcg/kg/day SC) should be started in patients with a hypoplastic marrow and a neutrophil count of < 0.5 X 109/L.
- Thrombocytopenic or anaemic patients should receive platelet or red cell transfusions respectively, as appropriate.
Topic Code: 8892