The composition of leukapheresis products impacts on the hematopoietic recovery after autologous transplantation independently of the mobilization regimen.
BACKGROUND
Effects of mobilization regimen on the composition of leukapheresis products (LPs) and on hematopoietic reconstitution after autologous peripheral blood progenitor cell transplantation (PBPCT) are not well known.


METHODS
The effects of three different mobilization regimens--stem cell factor (SCF) plus granulocyte colony stimulating factor (G-CSF) plus cyclophosphamide (CCP), G-CSF alone, and G-CSF plus CCP--on the composition of LPs from patients with nonhematologic PBPC malignancies compared to LPs from G-CSF-mobilized healthy donors and normal marrow (BM) samples were analyzed. The impact of LP composition on both short- and long-term engraftment after autologous PBPCT was also evaluated.


RESULTS
The most effective regimen for mobilization of CD34+ hematopoietic progenitor cells (HPCs) into peripheral blood was SCF, G-CSF, and CCP, providing the highest numbers of all CD34+ HPCs subsets analyzed. Patients mobilized with SCF plus G-CSF plus CCP showed the highest numbers of neutrophils and monocytes, whereas the highest numbers of lymphocytes and NK cells were observed in LPs from G-CSF-mobilized patients. The overall number of CD34+ HPCs was the strongest factor for predicting recovery of platelets, whereas the number of myelomonocytic-committed CD34+ precursors was the most powerful independent prognostic factor for WBC and neutrophil recovery. The overall number of CD4+ T cells returned showed an independent prognostic value for predicting the occurrence of infections, during the first year after transplant.


CONCLUSIONS
The use of different mobilization regimens modifies the overall number of CD34+ HPCs obtained during leukapheresis procedures, and also affects both the absolute and the relative composition of the LPs in different CD34+ and CD34- cell subsets.
Menéndez
Pablo
P
Department of Medicine, and the Cancer Investigation Center, University of Salamanca, Spain.
Caballero
Maria D
MD
Prosper
Felipe
F
Del Cañizo
Maria C
MC
Pérez-Simón
Jose A
JA
Mateos
Maria V
MV
Nieto
Maria J
MJ
Corral
Mercedes
M
Romero
Mercedes
M
García-Conde
Javier
J
Montalbán
Maria A
MA
San Miguel
Jesus F
JF
Orfao
Alberto
A
D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D001792:Blood Platelets / Q000187:drug effects; D001854:Bone Marrow Cells / Q000187:drug effects; D001943:Breast Neoplasms / Q000097:blood / Q000628:therapy; D002454:Cell Differentiation; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000494:pharmacology*; D004357:Drug Synergism; D005260:Female; D005434:Flow Cytometry; D018237:Germinoma / Q000097:blood / Q000628:therapy; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells / Q000187:drug effects*; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007937:Leukapheresis; D007958:Leukocyte Count; D007962:Leukocytes / Q000145:classification / Q000187:drug effects*; D008214:Lymphocytes / Q000187:drug effects; D008297:Male; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy; D009369:Neoplasms / Q000097:blood* / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011379:Prognosis; D019089:Stem Cell Factor / Q000008:administration & dosage / Q000494:pharmacology*
D018952:Antigens, CD34; D019089:Stem Cell Factor; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide