Factors influencing the collection of peripheral blood stem cells in patients with acute myeloblastic leukemia and non-myeloid malignancies.
Factors influencing the collection of autologous peripheral blood stem cells (PBSCs) were studied in 182 mobilization procedures performed on 145 consecutive patients with acute myeloblastic leukemia (AML; n=67) and with various non-myeloid malignancies (NMM; n=78). PBSC were collected following mobilization with chemotherapy, treatment with granulocyte colony-stimulating factor (G-CSF) or chemotherapy plus G-CSF. Fewer colony-forming unit granulocyte-macrophages (CFU-GMs) were collected from patients with AML than from patients with NMM (P<0.0001), although there were no differences in the numbers of CD34+ cells collected between both groups. Multiple regression analysis showed that chemotherapy alone was predictive of a low CD34+ yield in patients with NMM (regression coefficient (RC)=-2.1; P=0.003). In addition, the interactions "diagnosis mutliple myeloma (MM)xmobilization with chemotherapy" (RC=2.9; P=0.004) and "diagnosis MMxmobilization with chemotherapy plus G-CSF" (RC=2.1; P=0.04) also remained in the model, both showing a favorable influence. In AML, mobilization with chemotherapy plus G-CSF was associated with higher CD34+ yields (P=0.003). In this subgroup of patients, multiple regression analysis identified the number of cycles of previous chemotherapy (< or =2 cycles; RC=1.3; P=0.03) and peripheral blood counts (WBC > or =1.5 x 10(9)/l and monocytes >20%; RC=0.8; P=0.02) as the factors most predictive of CD34+ cell yield. These findings emphasize the need to optimize harvesting technique to enhance safety and minimize morbidity and costs of this valuable procedure.
Carral
A
A
Bone Marrow Transplant Unit, Hematology Service, University Hospital La Fe, 46009, Valencia, Spain.
de la Rubia
J
J
Martín
G
G
Mollá
S
S
Martínez
J
J
Sanz
G F
GF
Soler
M A
MA
Jarque
I
I
Jiménez
C
C
Sanz
M A
MA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001772:Blood Cell Count; D001853:Bone Marrow / Q000187:drug effects / Q000528:radiation effects; D003114:Colony-Forming Units Assay; D004357:Drug Synergism; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006801:Humans; D007937:Leukapheresis / Q000295:instrumentation / Q000379:methods; D007951:Leukemia, Myeloid / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D011878:Radiotherapy / Q000009:adverse effects; D012044:Regression Analysis; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor