Mobilization, collection, and immunomagnetic selection of peripheral blood CD34 cells in recovered aplastic anemia patients.
BACKGROUND
Most patients with severe aplastic anemia (sAA) respond to immunosuppression, but a significant number relapse or develop clonal abnormalities such as paroxysmal nocturnal hemoglobinuria, myelodysplasia, or leukemia. In principle, patients without matched sibling donors and older patients might benefit from transplantation of autologous hematopoietic peripheral blood progenitor cells (PBPCs) obtained during remission. Even patients who have clinically recovered from aplastic anemia have diminished hematopoietic progenitor cells, so the practicability of PBPC mobilization in these individuals is unknown.


METHODS
The feasibility of PBPC mobilization in nine patients with a history of sAA was evaluated. Granulocyte-colony-stimulating factor (10 microg/kg) was administered subcutaneously for 5 days and followed by a 12-L leukapheresis procedure.


RESULTS
Only two of the nine patients had sufficient mobilization of CD34 cells to merit collection; in these cases sufficient CD34 cells were obtained for autologous transplantation should the need arise.


CONCLUSIONS
PBPC collection is feasible only in a fraction of recovered AA patients.
Sloand
Elaine M
EM
Hematology Branch, National Heart, Lung, and Blood Institute, and the Mark O. Hatfield Clinical Research Center, National Institutes of Health, Bethesda, Maryland 20892, USA. sloande@nih.gov
Read
Elizabeth J
EJ
Scheinberg
Phillip
P
Tang
Yong
Y
More
Kenneth
K
Leitman
Susan F
SF
Maciejewski
Jaroslaw
J
Young
Neal S
NS
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D018952:Antigens, CD34; D002648:Child; D005240:Feasibility Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods* / Q000592:standards; D006412:Hematopoietic Stem Cells; D006801:Humans; D018189:Immunomagnetic Separation; D007937:Leukapheresis / Q000379:methods*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor