Prediction of hematopoietic stem cell yield after mobilization with granulocyte-colony-stimulating factor in healthy unrelated donors.

Abstract

The collection of hematopoietic stem cells from the peripheral blood of healthy donors has been established as a highly efficient method. Nevertheless, some donors have a moderate or poor chance of harvest success with standard mobilization regimens. We retrospectively reviewed data from 7216 unrelated healthy donors, who underwent granulocyte-colony-stimulating factor mobilization and consecutive leukapheresis for allogeneic stem cell transplantation. We tested different donor variables of potential influence and established a statistical model for prediction of upfront mobilization capacity and harvest success. In addition, we calculated the likelihood of a successful harvest dependent on predicted preapheresis CD34+ count and recipient weight. Female sex, older age, smoking, elevated lactate dehydrogenase, higher relative lymphocyte count, and higher large unstained cell count at baseline were negatively correlated with the CD34+ cell count on Day +5 (p < 0.0001). In contrast, higher platelet count, higher body mass index, higher absolute lymphocyte count, and higher relative monocyte count at baseline showed a positive correlation with the CD34+ count on Day +5 (p < 0.0001). Using a model built on these factors, we could significantly improve the prediction of harvest success compared to a basic model. The model allows the identification of female donors who eventually have a significant risk of harvest failure if requested to donate for recipients with a high body weight.