CD34+CD33- cells influence days to engraftment and transfusion requirements in autologous blood stem-cell recipients.
OBJECTIVE
To evaluate the reliability of CD34/CD33 subset enumeration as a predictor of hematopoietic repopulating potential in autologous blood stem-cell transplantation and to determine which patient and treatment-related factors affect the timing, quantity, and type of blood stem cells mobilized.


METHODS
We analyzed blood stem-cell collections from 410 consecutive cancer patients who received mobilization therapy and evaluated factors, including CD34+ subset quantities, that might influence engraftment kinetics and transfusion requirements in autologous blood stem-cell recipients.


RESULTS
The majority of patients (97%) mobilized CD34+33- cells, which were usually collected in the greatest quantity on the first day of apheresis. Patients who received only growth factor mobilized the highest percentage of CD34+33- cells. Extensive prior chemotherapy limited the collection of CD34+33- cells. In addition to patient diagnosis (P < .006) and total CD34+ cell dose (P = .0001), CD34+33- cell dose (P < .005) and percentage of CD34+33- cells (P < .005) were identified as independent factors significantly predictive of engraftment kinetics. CD34+33- cell dose (R2 < or = .177; P < .0001) was a strong and the only significant predictor of RBC and platelet transfusion requirements. Furthermore, independent of the total CD34+ cell dose, as the CD34+33- cell dose increased, days to neutrophil recovery, days to platelet recovery, and transfusion requirements decreased.


CONCLUSIONS
These findings show that CD34+33- cells are readily collected in most cancer patients and significantly influence engraftment kinetics and transfusion requirements in autologous blood stem-cell recipients. CD34+33- cell quantity of the blood stem-cell graft appears to be a more reliable predictor of hematopoietic recovery rates than total CD34+ cell quantity in this setting.
Pecora
A L
AL
Department of Medicine, Hackensack University Medical Center, NJ 07601, USA. rpreti@humed.com
Preti
R A
RA
Gleim
G W
GW
Jennis
A
A
Zahos
K
K
Cantwell
S
S
Doria
L
L
Isaacs
R
R
Gillio
A P
AP
Michelis
M A
MA
Brochstein
J A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000502:physiology*; D018952:Antigens, CD34 / Q000502:physiology*; D015214:Antigens, Differentiation, Myelomonocytic / Q000502:physiology*; D001772:Blood Cell Count; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016131:Lymphocyte Subsets / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D063268:Sialic Acid Binding Ig-like Lectin 3; D014182:Transplantation, Autologous / Q000502:physiology*
D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; C571163:CD33 protein, human; D063268:Sialic Acid Binding Ig-like Lectin 3