Comparison of processing four and five times the patients' blood volume during peripheral blood stem cell collection and analysis of CD34+38--and CD34+49d+ subsets during apheresis.
OBJECTIVE
We investigated whether increasing the patients' processed blood volume (BV) during peripheral blood stem cell collection (PBSCC) from four to five times leads to a greater yield of CD34+ cells. We also studied the kinetics of CD34+38- and CD34+49d+ subsets and compared the amount of transfused cells with engraftment.


METHODS
All patients ( n=20) received chemotherapy followed by G-CSF for PBSC mobilization. Samples from the patients' peripheral blood and the PBSC harvests were taken after processing 1-, 4-, and 5 times the patients' calculated BV.


RESULTS
The mean total yields of CD34+, CD34+38-, and CD34+49d+ cells were 15.69-, 1.13- and 4.17 x 10(6)/kg body weight, respectively. The mean increase for these subsets between 4- and 5 BV was 10%, 8%, and 21%, respectively. Based on the mean number of 2.25 (range 2-3) planned courses of high-dose chemotherapy (HDC) per patient, the mean yield of CD34+ cells per kg body weight and intended course of HDC after 4- and 5 BV was 6.31- and 6.97 x 10(6) ( P=0.014). Twenty HDC were evaluable for engraftment. There was some correlation between the number of transfused CD34+ and CD34+38- cells and WBC engraftment ( r = -0.66 and --0.69; P<0.01) and CD34+ cells and platelet engraftment ( r = -0.56; P= 0.013). No toxicity occurred during PBSCC, although the mean platelet count dropped by 50% which must be kept in mind regarding the additional application of anti-coagulants and the fact that most patients had large indwelling catheters.


CONCLUSIONS
Processing 4 BV is sufficient to collect >5 x 10(6) CD34+ cells/kg body weight and intended course of HDC in most patients, although extension to 5 BV further increases the total yield of CD34+ cells.
Bojko
P
P
University of Essen Medical School, Department of Internal Medicine (Cancer Research), West German Cancer Center, Hufelandstrasse 55, 45122 Essen, Germany. peter.bojko@uni-essen.de
Scharifi
M
M
Stössel
K
K
Seeber
S
S
D036541:ADP-ribosyl Cyclase; D051997:ADP-ribosyl Cyclase 1; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood*; D018952:Antigens, CD34 / Q000097:blood*; D000943:Antigens, Differentiation / Q000097:blood; D001781:Blood Component Removal; D001793:Blood Preservation / Q000379:methods; D001810:Blood Volume; D015925:Cryopreservation / Q000379:methods; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells / Q000145:classification / Q000166:cytology* / Q000473:pathology; D006801:Humans; D039441:Integrin alpha4; D008223:Lymphoma / Q000097:blood* / Q000628:therapy; D008297:Male; D008562:Membrane Glycoproteins; D008875:Middle Aged; D009244:NAD+ Nucleosidase / Q000097:blood; D009369:Neoplasms / Q000097:blood* / Q000628:therapy; D016201:Receptors, Lymphocyte Homing / Q000097:blood*; D020858:Tissue and Organ Harvesting / Q000379:methods
D015703:Antigens, CD; D018952:Antigens, CD34; D000943:Antigens, Differentiation; D008562:Membrane Glycoproteins; D016201:Receptors, Lymphocyte Homing; D039441:Integrin alpha4; D036541:ADP-ribosyl Cyclase; C498154:CD38 protein, human; D009244:NAD+ Nucleosidase; D051997:ADP-ribosyl Cyclase 1