Positive selection of CD34+ cells by immunoadsorption: factors affecting the final yield and hematopoietic recovery in patients with hematological malignancies and solid tumors.
There is a progressive increase in the use of selected hematopoietic progenitor cells after myeloablative therapy in patients affected by malignancies. Our goal was to determine which blood parameters, in the starting cell population, influence the concentration of CD34+ progenitors and the removal of unwanted cells in the final product. Also, we evaluated the hematopoietic recovery and toxicity associated with peripheral blood stem cell infusion. We retrospectively reviewed 53 procedures of positive selection of CD34+ cells, performed with the Ceprate SC immunoadsorption system, in 47 paticnts affected by various hematologic malignancies and solid tumors. An increased percentage of CD34+ cells in the starting fraction was associated both with the final purity and enrichment of CD34+ cells and with a decreased percentage of CD3+ and CD19+ cells in the final product. A low platelet count before selection had a borderlinc influence on the recovery of CD34+ cells. Forty patients received a median of 5 x 10(6) CD34+ cells per kg; the absolute neutrophil count (ANC) reached 0.5 x 10(9)/l in a median of 10 days whereas a PLT count above 20 x 10(9)/l was observed in 14 days. The reinfusion of selected CD34+ cells, containing a very low amount of dymethylsulfoxide. was well tolerated and no adverse reactions were observed. Autologous transplantation with selected CD34+ cells is a safe and well-tolerated procedure in patients affected by hematologic malignancies and solid tumors. Positive selection of CD34+ cells seems to be related to the quality of the apheresis products, particularly to the initial CD34+ cell and PLT content.
Department of Immunohematology, University Tor Vergata, Bambino Gesù Hospital, Rome, Italy. labcrio@tiscalinet.it
Antonio
A
Bruno
Tommaso
T
Caravita
Gaspare
G
Adorno
Giovanni
G
Del Poeta
Adriano
A
Venditti
Roberto
R
Stasi
Giovanna
G
Ballatore
Gianpaolo
G
Del Proposto
Alessandro
A
Lanti
Francesco
F
Zinno
Laura
L
Cudillo
Teresa
T
Dentamaro
Francesco
F
Buccisano
Anna
A
Tamburini
Susanna
S
Santinelli
Luca
L
Maurillo
Maria
M
Cantonetti
Maria Cristina
MC
Cox
Mario
M
Masi
Gianfranco
G
Catalano
Giancarlo
G
Isacchi
Sergio
S
Amadori
D018952:Antigens, CD34; D002452:Cell Count; D002469:Cell Separation / Q000379:methods / Q000592:standards*; D019337:Hematologic Neoplasms / Q000628:therapy; D006410:Hematopoiesis; D006412:Hematopoietic Stem Cells; D006801:Humans; D007163:Immunosorbent Techniques / Q000592:standards; D009369:Neoplasms / Q000628:therapy; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000592:standards*; D016896:Treatment Outcome
D018952:Antigens, CD34