The number of CD34+ cells in peripheral blood as a predictor of the CD34+ yield in patients going to autologous stem cell transplantation

✍ Scribed by A.L. Basquiera; P. Abichain; J.C. Damonte; B. Ricchi; A.G. Sturich; E.D. Palazzo; J.J. García

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 84 KB
• Volume: 21
• Category: Article
• ISSN: 0733-2459
• DOI: 10.1002/jca.20062

✦ Synopsis

The number of CD34+ cells in peripheral blood (PB) is a guide to the optimal timing to harvest peripheral blood progenitor cells (PBPC). The objective was to determine the number of CD34+ cells in PB that allows achieving a final apheresis product containing 1.5 • 10 6 CD34+ cells/kg, performing up to three aphereses. Between March 1999 and August 2003, patients with hematological and solid malignancies who underwent leukapheresis for autologous bone marrow transplantation were prospectively evaluated. Seventy-two aphereses in 48 patients were performed (mean 1.45 per patient; range 1-3). PBPC were mobilized with cyclophosphamide plus recombinant human granulocyte-colony stimulating factor (G-CSF) (n ¼ 40), other chemotherapy drugs plus G-CSF (n ¼ 7), or G-CSF alone (n ¼ 1). We found a strong correlation between the CD34+ cells count in peripheral blood and the CD34+ cells yielded (r ¼ 0.903; P < 0.0001). Using receiver-operating characteristic (ROC) curves, the minimum number of CD34+ cells in PB to obtain 1.5 • 10 6 /kg in the first apheresis was 16.48 cells/lL (sensitivity 100%; specificity 95%). The best cut-off point necessary to obtain the same target in the final harvest was 15.48 cells/lL, performing up to three aphereses (sensitivity 89%; specificity 100%). In our experience, 15 CD34+ cells/lL is the best predictor to begin the apheresis procedure. Based on this threshold level, it is possible to achieve at least 1.5 • 10 6 /kg CD34+ cells in the graft with £3 collections.