Roles of Peripheral Blood CD34+ Cell Count and Midpoint Collection CD34+ Cell Yield for Peripheral Blood Stem Cell Collections from Autologous Patients Mobilized by G-CSF and Plerixafor

Julie Chepovetsky, S. Choo Yoon, Amanda G. Blouin, Sharon Tindle, Andrea Bertinelli, Emeris Nash, Ding Wen Wu

Abstract


Autologous peripheral blood stem cell transplantation is used to treat multiple hematologic malignancies including multiple myeloma, lymphomas and amyloidosis. G-CSF plus plerixafor has increasingly become a viable first-line PBSC mobilization option in the autologous patients. The aim of our study was to determine whether peripheral blood CD34+ cell count (PB CD34) or midpoint collection CD34+ yield (MPY) is a better predictor of the final collection CD34+ yield (FY) to guide decision-making to ensure collection target achievement and, when possible, to reduce collection sessions for adult autologous PBSC patients mobilized with both G-CSF and plerixafor. Eighty-eight autologous patients who were mobilized by the 2-pronged regimen underwent 171 PBSC collection sessions in 2011. Retrospective data analysis for the PBSC collections showed: (1) Both PB CD34 and MPY correlate strongly with FY; (2) Reduction of apheresis sessions in 24 patients was achieved by decision-making based on FY estimation using PB CD 34 and/ or MPY. Reduction of apheresis sessions decreases the discomfort, inconvenience, cost, and time spent associated with the stem cell collection for the patients, and also decreases the cost and increases the efficiency of our apheresis operation. Based on the prediction value of either PB CD34 or MPY, a guideline is developed for our apheresis facility for autologous PBSC patients, and 1 increased TBV is preferred at most of the time. 


Keywords


Autologous peripheral blood stem cell collection, Peripheral blood CD34+ cell count, Collection CD34+ yield, Total blood volume, Collection efficiency

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References


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