Immature granulocyte fraction in the peripheral blood is a practical indicator for mobilization of CD34(+) cells.
We propose a simple parameter that improves prediction of the number of CD34(+) cells in blood cells collected by apheresis for autologous peripheral blood stem cell (PBSC) transplantation following administration of granulocyte colony-stimulating factor. The percentage of immature granulocytes including myeloblasts, promyelocytes, myelocytes, and metamyelocytes (LSI for left-shift index) immediately prior to the start of each apheresis correlated with the number of CD34(+) cells in PBSC collections (r = 0.79, P < 0.0001, Y = 0.227X - 0.99, R(2) = 0.623) much better than did the white blood cell count (r = 0.07), currently the most commonly used predictor in deciding the initiation of apheresis. We then used receiver operating characteristic (ROC) curves to determine a cutoff point for LSI to prevent unnecessary apheresis. At LSI > 7.5, sensitivity and specificity of cutoff points in the probability of obtaining >1.0 x 10(6) CD34(+) cells/kg BW were 93.3% and 94.3% (95% CI, 91.4-100.0%), respectively. When LSI reaches 15.25, nearly 100% of apheresis will attain the target CD34(+) cell dose. These findings indicate that LSI is a useful and simple method for predicting the yield of CD34(+) cells before the start of PBSC collection and avoiding unnecessary apheresis.
Endo-Matsubara
Mari
M
Departments of Cell Therapy/Transplantation Medicine and Hematology/Oncology, University of Tokyo Hospital and Graduate School of Medicine, Tokyo, Japan.
Ogawa
Seishi
S
Sasaki
Ko
K
Takahashi
Tsuyoshi
T
Chiba
Shigeru
S
Hirai
Hisamaru
H
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000096:biosynthesis* / Q000276:immunology; D001772:Blood Cell Count; D001773:Blood Cells / Q000166:cytology* / Q000276:immunology; D001781:Blood Component Removal; D002454:Cell Differentiation; D005260:Female; D006098:Granulocytes / Q000166:cytology* / Q000276:immunology; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D018952:Antigens, CD34