Impact of CD34+ pre-counting and plerixafor on autologous peripheral blood stem cell collection in Japanese university hospitals in eight years

Abstract

ObjectiveOver the past decade, there have been two major advancements in autologous peripheral blood stem cell (PBSC) collection, namely enumeration of CD 34+ cells for apheresis prediction and use of plerixafor to assist mobilization of PBSC. This study aimed to investigate changes in the efficacy of PBSC collection from two Japanese university hospitals over an eight-year period. Study design and methodsA series of 399 PBSC collection procedures from 239 patients with solid malignant tumors (ST, n = 42), malignant lymphoma (ML, n = 91), multiple myeloma (MM, n = 99), and others (amyloidosis and leukemia, n = 7) from two university hospitals from 2011 to 2018 were retrospectively analyzed. We also analyzed the effects of CD34+ pre-counting and plerixafor administration in improving CD34+ cell yield. ResultsUsing CD34+ pre-count as a reference, the frequency of apheresis was reduced and the yield of CD34+ cells increased in patients with ST. When administrating plerixafor, especially with a CD34+ pre-count <20/μL, the yield of CD34+ cells was significantly increased in patients with ML (p = 0.02) and MM (p = 0.03). ConclusionsWe verified that CD34+ cell counting and plerixafor administration contributed to effective PBSC collections in our hospitals for the eight-year study period. In patients with ST, CD34+ pre-count threshold for starting apheresis was ≥10/μL. CD34+ pre-count (<20/μL) was useful to select appropriate patients for plerixafor administration among the patients with ML and MM.