Leukapheresis after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation: a novel approach to harvest a second autograft.
BACKGROUND
Autologous peripheral blood progenitor cells (PBPCs) are usually collected after the administration of conventional-dose chemotherapy (CDCT) and growth factors. However, there are no data available concerning the collection of PBPCs after high-dose chemotherapy (HDCT) and autologous hematopoietic transplantation in a larger series.


METHODS
Patients (n = 30) underwent leukapheresis for PBPC harvest after CDCT. After HDCT and autografting, the collection of a second PBPC autograft was attempted.


RESULTS
Leukapheresis was performed after CDCT in all cases at a median of 118 CD34+ cells per microL (range, 18-589) and resulted in 6.4 x 10(6) CD34+ cells per kg (range, 1.7-29.0). After HDCT and autografting, 24 patients (80%) underwent secondary leukapheresis, although they had a significantly lower median of peripheral blood (PB) CD34+ cells (30/microL; range, 10-171; p < 0.001). In these patients a median of 3.6 x 10(6) CD34+ cells per kg (range, 1.6-10.1) was collected in the post-transplantation course. In the remaining six patients (20%) with PB CD34+ cells < 10 per microL, no PBPC harvesting was performed. These so-called poor mobilizers had received significantly less CD34+ cells for autologous transplantation than patients with successful post-HDCT mobilization (median, 2.5 x 10(6)/kg [range, 1.7-3.0] vs. 6.5 x 10(6)/kg [range, 3.2-19.6]; p < 0.001).


CONCLUSIONS
Collection of PBPCs is possible in most patients during the recovery phase of hematopoiesis after HDCT plus autografting, and the number of circulating PBPCs may be related to the CD34+ cell dose transfused by the preceding autograft.
Schwella
Nimrod
N
Division of Hematology/Oncology, Department of Internal Medicine, Philipps University Hospital, Marburg, Germany. schwella@med.uni-marburg.de
Braun
Andrea
A
Ahrens
Norbert
N
Rick
Oliver
O
Salama
Abdulgabar
A
D000328:Adult; D000465:Algorithms; D018952:Antigens, CD34 / Q000032:analysis; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods
D018952:Antigens, CD34; D000970:Antineoplastic Agents