A randomized comparison of peripheral blood hematopoietic progenitor cell level of 5/mm3 versus 50/mm3 as a surrogate marker to initiate efficient autologous blood stem cell collection
✍ Scribed by Min Kyoung Kim; Shin Kim; Geundoo Jang; Sung Sook Lee; Sun Jin Sym; Dae Ho Lee; Sang We Kim; Seongsoo Jang; Chan Jeong Park; Hyun Sook Chi; Jooryung Huh; Cheolwon Suh
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 111 KB
- Volume
- 22
- Category
- Article
- ISSN
- 0733-2459
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✦ Synopsis
Abstract
We previously showed that at least 5/mm^3^ hematopoietic progenitor cells (HPCs) could be used as a marker for initiating autologous blood stem cell collection (ABSCC). However, the timing of efficient ABSCC following mobilization is still to be determined. We conducted a prospective, randomized comparison of 5/mm^3^ versus50/mm^3^ peripheral blood (PB) HPCs as a surrogate marker to initiate efficient ABSCC. Forty‐five consecutive patients, 26 with multiple myeloma (MM) and 19 with non‐Hodgkin's lymphoma (NHL), were enrolled between October 2004 and October 2006. Chemotherapy was cyclophosphamide 4 g/m^2^ for MM and ESHAP (etoposide, methylprednisolone, high‐dose cytarabine, and cisplatin), with or without Rituximab, for NHL. Circulating HPCs were monitored daily with the Sysmex SE9000 automated hematology analyzer, and harvested CD34+ cells were counted by flow cytometry. ABSCC was initiated when HPC levels reached at least 5/mm^3^ (HPC5 group) or 50/mm^3^ (HPC50 group). The median number of harvested CD34+ cells was 15.0 × 10^6^/kg and 21.0 × 10^6^/kg in the HPC5 and HPC50 groups, respectively (P = 0.23). Optimal collection (>5 × 10^6^ CD34+ cells/kg) in a single session (day 1) was attained in 15 HPC5 patients (63%) and in 14 HPC50 patients (67%), and targeted collection of 5 × 10^6^ CD34+ cells/kg was achieved in 100 and 95% of HPC5 and HPC50 patients, respectively (P = 0.47), with a median number of 1 apheresis in both groups (P = 0.58). There were no between group differences in optimal collection rate on day 1, median number of aphereses to achieve optimal collection, and overall optimal collection rate. HPC ≥ 5/mm^3^ and ≥50/mm^3^ are both reliable indices for the timing of ABSCC. J. Clin. Apheresis, 2007. © 2007 Wiley‐Liss, Inc.