Can the stem cell mobilization technique influence CD34+cell collection efficiency of leukapheresis procedures in patients with hematologic malignancies?

被引:32
|
作者
Gidron, A [1 ]
Verma, A [1 ]
Doyle, M [1 ]
Boggio, L [1 ]
Evens, A [1 ]
Gordon, L [1 ]
Singhal, S [1 ]
Tallman, M [1 ]
Williams, S [1 ]
Winter, J [1 ]
Mehta, J [1 ]
机构
[1] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Feinberg Sch Med, Div Hematol Oncol,Hematopoiet Stem Cell Transplan, Chicago, IL 60611 USA
关键词
CD34+cells; leukapheresis; collection efficiency; cell separator;
D O I
10.1038/sj.bmt.1704781
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
A total of 415 leukaphereses in 201 patients stimulated with growth factor (GF; n = 119) or chemotherapy-GF ( n = 296) were studied to determine CD34+ cell collection efficiency (CE). The pre-apheresis leukocyte count was 1 - 93 x 10(9)/l (median 20), and peripheral blood CD34 count (PBCD34) was 1 - 1104/mul (median 19). The total number of CD34+ cells collected was 4 - 6531 x 10(6) ( median 151); corresponding to 0.1 - 111.4 x 10(6) ( median 2.3) per kg. There was strong correlation between PBCD34 and the number of CD34+ cells collected (r =0.9; P<.0001). CE was 7 - 145% (median 46). On multiple regression analysis, a higher leukocyte count (P<.0001) was the most important predictor of lower CE. CE with leukocytes <0 was 7 - 145% ( median 53%) compared to 10 - 132% ( median 40%) with leukocyte >= 20 (P<.0001). In all, 61% of the apheresis procedures performed after chemotherapy-GF occurred when leukocytes were <0 compared to 21% of those performed after GF alone (P<.0001). We conclude that mobilizing patients with the combination of chemotherapy and GF rather than GF alone leads to leukapheresis being performed when the leukocyte count is low - in a range that results in optimum CD34+ cell CE. Autologous stem cells should be mobilized with chemotherapy-GF rather than GF alone whenever possible.
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页码:243 / 246
页数:4
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