title: A new model for predicting the timing of leukapheresis on the basis of CD34+ cell and hematopoietic progenitor cell levels.
abstract: We developed a model (depending on peripheral CD34(+) cell count and hematopoietic progenitor cell count) to determine the optimal timing of 3-day leukapheresis in patients pretreated with chemotherapy and G-CSF. Marrow potentials were identified on the basis of three patterns of leukapheretic yield. Pattern 1 predicted good marrow potential. The positive predictive value of a first-day leukapheretic yield of >1 x 10(6) CD34(+) cells/kg (mean 3-day yield = 8.18 x 10(6) CD34(+) cells/kg, n = 11) was 100%. Pattern 2 predicted poor marrow potential. The negative predictive value of a 3-day leukapheretic yield of >1 x 10(6) CD34(+) cells/kg (3-day yield = 0.26 x 10(6) CD34(+) cells/kg, n = 1) was 100%. Pattern 3 met neither of the above criteria (mean 3-day yield = 1.37 x 10(6) CD34(+) cells/kg, n = 19). The marrow potential was borderline and patients could be further divided into two subgroups according to peripheral CD34(+) cell counts when WBC reached >10,000/microl. The mean yield differed significantly between pattern 1 and 3 (P < 0.001). For patients with good marrow potential, leukapheresis should begin as soon as the WBC count is >5,000/microl. Patients with borderline marrow potential may benefit from delaying leukapheresis until the WBC level is >10,000/microl and leukapheresis extended more than 3 days.
authors.affiliation: Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
authors.forename: Liang-Tsai
authors.initials: LT
authors.lastname: Hsiao
authors.forename: Shu-Chou
authors.initials: SC
authors.lastname: Chaou
authors.forename: Jyh-Pyng
authors.initials: JP
authors.lastname: Gau
authors.forename: Tzu-Chi
authors.initials: TC
authors.lastname: Lee
authors.forename: Ying-Yih
authors.initials: YY
authors.lastname: Shih
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: Ying-Chung
authors.initials: YC
authors.lastname: Hong
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chen
authors.forename: Mu-Hsin
authors.initials: MH
authors.lastname: Chang
authors.forename: Ya-Hsu
authors.initials: YH
authors.lastname: Yang
authors.forename: Po-Min
authors.initials: PM
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis*; D002452:Cell Count; D005260:Female; D006412:Hematopoietic Stem Cells; D006801:Humans; D007937:Leukapheresis / Q000592:standards*; D007962:Leukocytes / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009369:Neoplasms / Q000188:drug therapy / Q000628:therapy*; D011379:Prognosis; D013997:Time Factors
chemical_list: D018952:Antigens, CD34