title: Mobilization, harvesting and selection of peripheral blood stem cells in patients with autoimmune diseases undergoing autologous hematopoietic stem cell transplantation.
abstract: Peripheral blood stem cells (PBSC) were mobilized in 130 patients with autoimmune diseases undergoing autologous hematopoietic stem cell transplantation using cyclophosphamide 2 g/m(2) and either granulocyte colony-stimulating factor (G-CSF) 5 mcg/kg/day (for systemic lupus erythematosus (SLE) and secondary progressive multiple sclerosis, SPMS) or G-CSF 10 mcg/kg/day (for relapsing remitting multiple sclerosis (RRMS), Crohn's disease (CD), systemic sclerosis (SSc), and other immune-mediated disorders). Mobilization-related mortality was 0.8% (one of 130) secondary to infection. Circulating peripheral blood (PB) CD34(+) cells/microl differed significantly by disease. Collected CD34(+) cells/kg/apheresis and overall collection efficiency was significantly better using Spectra apheresis device compared to the Fenwall CS3000 instrument. Patients with SLE and RRMS achieved the lowest and the highest CD34(+) cell yields, respectively. Ex vivo CD34(+) cell selection employing Isolex 300iv2.5 apparatus was significantly more efficient compared to CEPRATE CS device. Circulating PB CD34(+) cells/microl correlated positively with initial CD34(+) cells/kg/apheresis and enriched product CD34(+) cells/kg. Mean WBC and platelet engraftment (ANC>0.5 x 10(9)/l and platelet count >20 x 10(9)/l) occurred on days 9 and 11, respectively. Infused CD34(+) cell/kg dose showed significant direct correlation with faster white blood cell (WBC) and platelet engraftment. When adjusted for CD34(+) cell/kg dose, patients treated with a myeloablative regimen had significantly slower WBC and platelet recovery compared to non-myeloablative regimens.
authors.affiliation: Division of Immunotherapy, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: L
authors.initials: L
authors.lastname: Statkute
authors.forename: L
authors.initials: L
authors.lastname: Verda
authors.forename: Y
authors.initials: Y
authors.lastname: Oyama
authors.forename: A
authors.initials: A
authors.lastname: Traynor
authors.forename: M
authors.initials: M
authors.lastname: Villa
authors.forename: T
authors.initials: T
authors.lastname: Shook
authors.forename: R
authors.initials: R
authors.lastname: Clifton
authors.forename: B
authors.initials: B
authors.lastname: Jovanovic
authors.forename: J
authors.initials: J
authors.lastname: Satkus
authors.forename: Y
authors.initials: Y
authors.lastname: Loh
authors.forename: K
authors.initials: K
authors.lastname: Quigley
authors.forename: K
authors.initials: K
authors.lastname: Yaung
authors.forename: E
authors.initials: E
authors.lastname: Gonda
authors.forename: N
authors.initials: N
authors.lastname: Krosnjar
authors.forename: D
authors.initials: D
authors.lastname: Spahovic
authors.forename: R K
authors.initials: RK
authors.lastname: Burt
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000302:isolation & purification*; D001327:Autoimmune Diseases / Q000097:blood* / Q000628:therapy; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007937:Leukapheresis / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34