title: Pre-mobilization therapy blood CD34+ cell count predicts the likelihood of successful hematopoietic stem cell mobilization.
abstract: We examined pre-mobilization blood CD34+ cell count to predict ability to mobilize adequate peripheral blood progenitor cells (PBPC) in 106 cancer patients and 36 allogeneic donors. Mean pre-mobilization therapy blood CD34+ cell count was 3.1 cells x 10(6)/l (s.d. = 3.9, r = 0.3-37) and mean CD34+ cells collected were 5.3 x 10(6) cells/kg/leukapheresis procedure (s.d. = 7.0, r = 0.03-53). Yields correlated with pre-mobilization CD34+ cells x 10(6)/l (r = 0.37, P-value < 0.0001); correlation was stronger in allogeneic donors (r = 0.56, P-value = 0.0004) and males (r = 0.46, P-value < 0.0001). Based on classification and regression tree multivariate analysis, the predictive value of pre-mobilization blood CD34+ cell count was confounded by other variables, including age, gender, mobilization regimen and malignancy type. We generated an algorithm to predict a minimum PBPC yield of 1 x 10(6) CD34+ cells/kg/leukapheresis procedure after mobilization. A threshold pre-mobilization blood CD34+ cell count of 2.65 cells x 10(6)/l was the most important decision point in predicting successful mobilization. Only 2% of subjects with pre-mobilization blood CD34+ cell counts > 2.65 cells x 10(6)/l did not achieve the minimum per apheresis, whereas 24% with pre-mobilization values below threshold had inadequate mobilization. Prospectively identifying individuals at risk for mobilization failure would allow for improved treatment planning, resource utilization and time saving.
authors.affiliation: Department of Epidemiology and Biostatistics, University Hospitals of Cleveland, Cleveland, OH 44106, USA.
authors.forename: P
authors.initials: P
authors.lastname: Fu
authors.forename: R K
authors.initials: RK
authors.lastname: Bagai
authors.forename: H
authors.initials: H
authors.lastname: Meyerson
authors.forename: D
authors.initials: D
authors.lastname: Kane
authors.forename: R M
authors.initials: RM
authors.lastname: Fox
authors.forename: R J
authors.initials: RJ
authors.lastname: Creger
authors.forename: B W
authors.initials: BW
authors.lastname: Cooper
authors.forename: S L
authors.initials: SL
authors.lastname: Gerson
authors.forename: M J
authors.initials: MJ
authors.lastname: Laughlin
authors.forename: O N
authors.initials: ON
authors.lastname: Koc
authors.forename: H M
authors.initials: HM
authors.lastname: Lazarus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D018952:Antigens, CD34 / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D007958:Leukocyte Count / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000628:therapy; D010976:Platelet Count / Q000379:methods; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor