title: Early total white blood cell recovery is a predictor of low number of apheresis and good CD34(+) cell yield.
abstract: OBJECTIVE
  We analysed peripheral blood progenitor cell (PBPC) mobilisation and collection in order to assess the main factors related to CD34(+) cell yields in patients affected by haematological malignancies.
  
  
  METHODS
  The features of CD34(+) cell mobilisation of patients with haematological malignancies that underwent autologous bone marrow transplantation were examined. Mobilisation chemotherapy consisted mainly of cyclophosphamide (CY) 4 or 7 g/m(2) followed by growth factors. Leukapheresis was started when the WBC counts reached 1.0x10(9)/l with the aim to collect at least 5x10(6) CD34(+) cells/kg body weight. The aphereses were performed on continuous-flow blood cell separators. The analysed variables were: age, diagnosis, CT mobilisation regimen, type of growth factor, number of previous CT lines, prior radiotherapy, days for WBC recovery and number of aphereses procedures to achieve the target of CD34(+) cells.
  
  
  RESULTS
  There were 41 consecutive patients (26 M/15 F): 21 non-Hodgkin's lymphoma (NHL), 15 Hodgkin's disease (HD), two chronic myeloid leukaemia (CML) and three multiple myeloma (MM). Eleven patients could not collect the proposed threshold of CD34(+) cells. CY 4 mobilised patients recovered WBC counts in less days (P=0.03). By ANOVA, the days to WBC recovery had a linear function of the predictors "number of aphereses" and "type of mobilisation CT" (coefficients: 0.86 and 0.95, respectively). For the number of aphereses and WBC recovery after CT mobilisation, we obtained a correlation coefficient of 0.36 (P=0.02).
  
  
  CONCLUSIONS
  This study shows that it is feasible to mobilise and collect PBPC in patients previously treated with CT with or without RT. There was a linear correlation between the days for WBC recovery and the number of aphereses needed to collect the target number of CD34(+) cells. The study suggests that early WBC recovery, using mainly CY 4 mobilisation chemotherapy, is an important predictor of a low number of aphereses to achieve a good CD34(+) yield.
authors.affiliation: Haematology and Blood Transfusion Centre, Haemocentro/Unicamp, State University of Campinas, P.O. Box 6198, Barao Geraldo, 13081-970, Campinas, SP, Brazil.
authors.forename: J F
authors.initials: JF
authors.lastname: Marques
authors.forename: A C
authors.initials: AC
authors.lastname: Vigorito
authors.forename: F J
authors.initials: FJ
authors.lastname: Aranha
authors.forename: I
authors.initials: I
authors.lastname: Lorand-Metze
authors.forename: E C
authors.initials: EC
authors.lastname: Miranda
authors.forename: E C
authors.initials: EC
authors.lastname: Lima Filho
authors.forename: M
authors.initials: M
authors.lastname: Valbonesi
authors.forename: G
authors.initials: G
authors.lastname: Santini
authors.forename: C A
authors.initials: CA
authors.lastname: De Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001772:Blood Cell Count; D053456:Caspase 14; D020169:Caspases / Q000008:administration & dosage; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000494:pharmacology; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology; D019337:Hematologic Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells; D006801:Humans; D017053:Infection Control; D007937:Leukapheresis; D007958:Leukocyte Count; D007963:Leukocytes, Mononuclear; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000494:pharmacology; D013997:Time Factors
chemical_list: D018952:Antigens, CD34; D011994:Recombinant Proteins; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D003907:Dexamethasone; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide; C506446:CASP14 protein, human; D053456:Caspase 14; D020169:Caspases; D002945:Cisplatin