Abstract
To evaluate factors affecting peripheral blood hematopoietic stem cell yield in patients undergoing large-volume leukapheresis for autologous peripheral blood stem cell collection. Data from 304 consecutive autologous peripheral blood stem cell donors mobilized with hematopoietic growth factor (usually G-CSF), associated or not with chemotherapy, at Hospital Israelita Albert Einstein between February 1999 and June 2010 were retrospectively analyzed. The objective was to obtain at least 2 × 106 CD34+ cells/kg of body weight. Pre-mobilization factors analyzed included patient's age, gender and diagnosis. Post mobilization parameters evaluated were pre-apheresis peripheral white blood cell count, immature circulating cell count, mononuclear cell count, peripheral blood CD34+ cell count, platelet count, and hemoglobin level. The effect of pre and post-mobilization factors on hematopoietic stem cell collection yield was investigated using logistic regression analysis (univariate and multivariate approaches). Pre-mobilization factors correlating to poor CD34 + cell yield in univariate analysis were acute myeloid leukemia (p = 0.017) and other hematological diseases (p = 0.023). Significant post-mobilization factors included peripheral blood immature circulating cells (p = 0.001), granulocytes (p = 0.002), hemoglobin level (p = 0.016), and CD34+ cell concentration (p < 0.001) in the first harvesting day. However, according to multivariate analysis, peripheral blood CD34+ cell content (p < 0.001) was the only independent factor that significantly correlated to poor hematopoietic stem cell yield. In this study, peripheral blood CD34+ cell concentration was the only factor significantly correlated to yield in patients submitted to for autologous collection.
Highlights
High-dose chemotherapy, together with hematopoietic stem cell (HSC) harvest, has been successfully used in the management of a variety of malignant and nonmalignant diseases[1]
Autologous peripheral blood stem cells (PBSC) are usually collected by leukapheresis during hematologic recovery phase from the administration of the mobilizing agents
Data from 304 consecutive autologous PBSC donors mobilized with granulocyte colony-stimulating factor (G-CSF) associated or not with chemotherapy at Hospital Israelita Albert Einstein (HIAE) between February 1999 and June 2010 were retrospectively analyzed
Summary
High-dose chemotherapy, together with hematopoietic stem cell (HSC) harvest, has been successfully used in the management of a variety of malignant and nonmalignant diseases[1]. Autologous PBSC are usually collected by leukapheresis during hematologic recovery phase from the administration of the mobilizing agents. LVL was reported as a safe and useful strategy to maximize autologous CD34+ cell yield especially in patients with low PB CD34+ cell concentration[13,14,15,16,17,18]. From 5 to 40% of patients undergoing autologous PBSC collection failed to achieve the minimum dose of 2 x 106 CD34+ cell/ kg body weight considering a single mobilization attempt. There is still no specific factor to identify a poor mobilizer(7,19.20)
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