Circulating Endothelial Cell Kinetics and Their Potential Predictive Value During Mobilization Procedure

Objective: Circulating endothelial cells (CECs) in patients with hematological malignancies are assessed as a noninvasive marker of angiogenesis. The aim of this study was to evaluate the numbers of CECs and their subsets during mobilization of hematopoietic stem cells. Patients and methods: Thirty-eight patients were enrolled to the study (19 females and 19 males) at median age of 56.5 years. The group consisted of patients with multiple myeloma (26), lymphoma (10), and acute myeloid leukemia (2). Blood samples were collected before chemotherapy (0), 1 day after chemotherapy (Cht+1), on the day G-CSF commenced (G0), after 1 day of G-CSF (G+1), and on the day of the first apheresis. CECs were evaluated by four-color flow cytometry. Circulating progenitor cells were defined as CD45-/CD34+/CD31+/CD133+. Apoptotic CECs (ApoCECs) were defined as CD146+/AnnexinV+. Results: Median (Me) CECs number was 10.5/mu l and it decreased after chemotherapy (Me=8.3/mu l, P<0.001 when compared with baseline). Based on the number of aphereses needed to obtain 2 x 10(6)/kg CD34+ cells, patients were divided into highly efficient (one apheresis) and poorly efficient mobilizers (two or more aphereses). Median ApoCEC at Day G+1 was lower in highly efficient than in poorly efficient mobilizers (Me=3.1/mu l vs. Me=5.1/mu l, P=0.02). ApoCEC at Day G+1 correlated with the number of aphereses (r=0.48, P=0.03). In multivariate analysis, ApoCEC at Day G+1 was an independent factor for successful mobilization during one apheresis. Conclusions: CECs and their subsets change significantly during mobilization of HSCs. ApoCECs measured at the time of G-CSF commencement can predict the efficacy of HSC collection. J. Clin. Apheresis 28:341-348, 2013. (c) 2013 Wiley Periodicals, Inc.