Influence of preapheresis clinical factors on the efficiency of CD34+ cell collection by large-volume apheresis

Abstract

Summary:We evaluated 120 leukapheresis procedures (93 patients), in order to detect clinical factors that influence the efficiency of CD34+ collection using Cobe Spectrat cell separators. Hematocrit was 427% and platelet count 430 000/ll in 495% of patients. Platelet transfusions were given if the postprocedure count was o20 000/ll. Multiple regression analysis was used to analyze putative factors, and a predictive equation defined by stepwise regression modeling. The mean efficiency was 0.59 (s.d. 0.27). Sex (M4F; P ¼ 0.01), the volume processed (inversely; P ¼ 0.01) and CD34+ cell count (inversely; P ¼ 0.04) were associated with efficiency, whereas hematocrit, platelet or leukocyte count, catheter type and patient weight were not. The effect size for predictive factors was small (R 2 ¼ 0.21). Adverse events were limited to hypocalcemia. We conclude that female sex, volume processed and CD34+ cell count adversely influence the efficiency of CD34+ cell leukapheresis. However, the impact of volume and CD34+ cell count is small, and likely to be offset by the influence of these same factors on overall yield. Leukapheresis appears to be safe and efficient for autologous blood and marrow transplantation patients with hematocrit 427% and platelet count 430 000/ll.

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

“…Overall, the CE of 46% seen here is in keeping with that reported by others 4,6,7 and by us in a smaller number of patients. 2,3 Age, ideal body weight, and underlying disease did not correlate with CE.…”

“…2,3 Age, ideal body weight, and underlying disease did not correlate with CE. While it has been reported elsewhere that female sex favorably impacts CE, 4 our results do not indicate any difference in CE between men and women.…”

Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

“…Standard or normalvolume leukapheresis (NVL) procedure usually processes 2.5 to 3 times the patient's total blood volume (TBV), whereas in large-volume leukapheresis (LVL), 3 to 6 times the patient's TBV is processed. 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) . Unfortunately, from 5 to 40% of patients undergoing autologous PBSC collection failed to achieve the minimum dose of 2 x 10 6 CD34+ cell/ kg body weight considering a single mobilization attempt.…”

Flow cytometric CD34+ stem cell enumeration: Lessons from nine years' external quality assessment within the Benelux countries

“…Each send-out, from Spring 1996 to Autumn 2004 was chronologically assigned with a unique number (i.e., [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. In this way, we analyzed any effect of the EQA program on the results of the participants as a function of time.…”

“…This emphasizes the need for an adequate prediction of engraftment potency of HSCs in patients after receiving myeloablative therapy followed by HSC transplantation (8)(9)(10)(11). Furthermore, enumeration of CD34þ cells has been shown to be useful in con-siderations of peripheral blood stem cell harvesting (12)(13)(14)(15)(16) and in comparing the efficacy of various PB stem cell mobilization strategies (reviewed by Fruehauf and Kessinger and Sharp) (17,18). Furthermore, CD34þ cell enumeration is useful for monitoring the stem cell yield during graft manipulations, such as immunomagnetic selections, ex vivo expansion, or genetic modifications of HSCs.…”