Midpoint CD34 measurement as a predictor of PBPC product yield in pediatric patients undergoing high-dose chemotherapy.
High-dose chemo/radiotherapy of sensitive tumors requires PBPC rescue doses of >3 x 10(6) CD34/kg (range: 3-20 x 10(6) CD34/kg). Because of the diversity of stem cell treatment protocols and clinical presentation of patients at the time of peripheral blood progenitor cell (PBPC) harvest, the use of the mid-point CD34 positive cell measurement was initiated to predict the final CD34-positive cell product yield/stem cell harvest. The measurement of CD34-positive cells at the mid-point of the initial setting of 5 total blood volumes (TBV) allows for the extension, shortening, or no change in the TBV processing to achieve a maximum goal of CD34-positive cells/kg body weight required for stem cell transplantation. The estimation of mid-point CD34-positive cells guided our center to extend 22 procedures, shorten 26 procedures, and leave 20 procedures unchanged. This investigation addresses three aspects of PBPC collection in pediatric patients: (1) the processing of large blood volumes (more than the defined 3 TBV and maximum up to 13 TBV in one session) to achieve good efficiency of the procedure; (2) the use of the mid-point CD34 measurement at 2.5 of 5 TBV initially set to predict the maximum goal of CD34 cells /kg needed on the same day of PBPC collection; and (3) PBPC collection in pediatric patients <10 kg body weight (as low as 5.8 kg body weight).
Sidhu
Rameshwar S
RS
Department of Pathology and Department of Pediatrics-Hematology and Oncology Division, University of Colorado Health Sciences Center, The Children's Hospital, Denver, Colorado 80262, USA. rameshwar.sidhu@uchsc.edu
Orsini
Edmund
E
Giller
Roger
R
Quinones
Ralph
R
Foreman
Nicholas K
NK
Thompson
Hannis
H
Brimhall
Brad
B
Walton
Karen
K
Croskell
Melissa
M
Le
Tuan N
TN
D000293:Adolescent; D018952:Antigens, CD34 / Q000096:biosynthesis*; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000379:methods*; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D013234:Stem Cells / Q000166:cytology / Q000378:metabolism; D013997:Time Factors
D018952:Antigens, CD34; D000970:Antineoplastic Agents