A new model for predicting the timing of leukapheresis on the basis of CD34+ cell and hematopoietic progenitor cell levels.
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.
Teng
Hao-Wei
HW
Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Hsiao
Liang-Tsai
LT
Chaou
Shu-Chou
SC
Gau
Jyh-Pyng
JP
Lee
Tzu-Chi
TC
Shih
Ying-Yih
YY
Liu
Chun-Yu
CY
Hong
Ying-Chung
YC
Chen
Ming-Huang
MH
Chang
Mu-Hsin
MH
Yang
Ya-Hsu
YH
Chen
Po-Min
PM
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
D018952:Antigens, CD34