Daily measurements of blood CD34+ cells after stem cell mobilization predict stem cell yield and posttransplant hematopoietic recovery.
The value of daily monitoring of the blood CD34+ cell concentration as a guide to the optimal timing of stem cell harvests was studied in 60 patients who underwent 66 stem cell mobilizations and 189 leukaphereses. There was a highly significant correlation between the blood CD34+ count and the CD34+ cell content in the apheresis product of the same day (r = 0.904, p < 0.01). Thus, the target yield of 4 x 10(6) CD34+ cells/kg can be harvested in one or two leukaphereses when the blood CD34+ cell count exceeds 50 x 10(6)/L. However, an insufficient harvest is to be expected when the blood CD34+ cell count is below 20 x 10(6)/L. The data from 35 autologous blood cell transplantations with a minimum CD34+ cell yield of 1.5 x 10(6)/kg showed that the recovery of blood neutrophil counts to 1.0 x 10(9)/L occurred in all patients within 9-14 days, but the time to recovery of the platelet counts to 20 x 10(9)/L may exceed 14 days, especially if the CD34+ cell content is below 4 x 10(6)/kg. Daily monitoring of blood CD34+ cell counts is a rapid and reliable means to guide the timing of stem cell collections. The count predicts well the CD34+ cell content of the harvests, the number of leukaphereses needed, and the speed of hematopoietic recovery.
Remes
K
K
Department of Medicine, Turku University Central Hospital, Finland.
Matinlauri
I
I
Grenman
S
S
Itälä
M
M
Kauppila
M
M
Pelliniemi
T T
TT
Salminen
E
E
Vanharanta
R
R
Rajamäki
A
A
D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood*; D018952:Antigens, CD34 / Q000097:blood*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000379:methods; D001804:Blood Transfusion, Autologous; D001943:Breast Neoplasms / Q000628:therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006410:Hematopoiesis / Q000187:drug effects; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007958:Leukocyte Count; D008223:Lymphoma / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008875:Middle Aged; D015166:Monitoring, Immunologic; D009101:Multiple Myeloma / Q000628:therapy*; D009369:Neoplasms / Q000628:therapy*; D009504:Neutrophils; D010051:Ovarian Neoplasms / Q000628:therapy; D011237:Predictive Value of Tests; D012044:Regression Analysis; D015203:Reproducibility of Results
D015703:Antigens, CD; D018952:Antigens, CD34; D000970:Antineoplastic Agents; D015415:Biomarkers; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide