Peripheral blood hematopoietic stem cell mobilization and collection efficacy is not an independent prognostic factor for autologous stem cell transplantation.
BACKGROUND
The successful mobilization and collection of hematopoietic stem cells are dependent on a number of clinical factors such as previous chemotherapy and disease stage. The aim of this retrospective study was to determine whether the effectiveness of mobilization and collection is an independent prognostic factor for autologous stem cell transplantation outcome.


METHODS
A total of 358 patients who received transplants from January 2003 to December 2004 (201 male and 157 female patients, ages from 2.7 to 77.3 years with median of 53 years of age) underwent autologous hematopoietic stem cell collection after mobilization with granulocyte-colony-stimulating factor (G-CSF) or G-CSF plus chemotherapy priming. This retrospective study included patients with diagnoses of acute myelogenous leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, and solid tumors. All patients underwent stem cell collection until a target or a minimum CD34+ cell dose was reached. Correlations were performed between stem cell mobilization and/or collection efficacy and transplantation outcomes.


RESULTS
In general, both larger reinfused CD34+ cell dose and shorter number of days for the stem cell count to reach the minimum of 2 x 10(6) per kg CD34+ cells do not foster quicker engraftment. Reinfused CD34+ cell dose of less than 12 x 10(6) and number of days stem cell collection to reach this minimum CD34+ cell dose did not independently affect the overall survival (OS) or disease-free survival (DFS).


CONCLUSIONS
The effectiveness of hematopoietic stem cell mobilization and collection as defined as number of days to reach a CD34+ cell dose of 2 x 10(6) per kg should not be used independently to forecast posttransplantation prognosis, engraftment, DFS, and OS.
Wang
Shirong
S
Department of Transfusion Medicine, Division of Pathology, City of Hope National Medical Center, Duarte, California 91010, USA. swang@coh.org
Nademanee
Auayporn
A
Qian
Dajun
D
Dagis
Andrew
A
Park
Hyun-Soon
HS
Fridey
Joy
J
Smith
Eileen
E
Snyder
David
D
Somlo
George
G
Stein
Anthony
A
Rosenthal
Joseph
J
Falk
Peter
P
Kogut
Neil
N
Palmer
Joycelynne
J
Gaal
Karl
K
Kim
Young
Y
Bhatia
Ravi
R
Yuan
Shan
S
Kay
Candace
C
Weiss
Lawrence
L
Forman
Stephen
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006689:Hodgkin Disease / Q000378:metabolism / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor