title: Large-volume-apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients.
abstract: Given that pre-apheresis CD34(+) cell count (PA-CD34) predicts the apheresis' yield, a minimum of 5 to 20 PA-CD34/microl is required in many institutions to initiate cell collection. The aim of this study was to clarify whether large-volume-apheresis (LVA) could facilitate progenitor cell transplantation in patients with low PA-CD34. Apheresis was initiated in 226 patients, disregarding PA-CD34, at days: +5 in G-CSF, +10 in cyclophosphamide+G-CSF, and +15 to +20 in other chemotherapy+G-CSF mobilization, when leucocytes >2.5 x 10(9)/L. Four times the blood volume was processed. Patients were grouped according to their PA-CD34: >or=10/microl (group-A, n = 143); <10/microl but >or=5/microl (group-B, n = 40) and <5/microl (group-C, n = 43). No differences were found in diagnoses, gender, age, previous treatments or mobilization regimen between groups. Enough CD34(+) cells (>1.9 x 10(6)/kg) were obtained in 31 patients (72%) from group-C, although in this group two mobilizations were needed in 20 patients (46.5%), compared to 5 (3.5%) and 1 (2.5%) in groups A and B, respectively (P < 0.01). Evenly three apheresis or more were required in 28 patients (65.1%) from group-C, compared to 8 (5.6%) and 6 (15.0%) in groups A and B, respectively (P < 0.01). In conclusion LVA can facilitate autologous transplantation in poor-mobilizer-patients, low PA-CD34 should not be an inflexible exclusion factor.
authors.affiliation: Servicio de Hematología, Hospital Virgen de la Arrixaca, Murcia, Spain. juliana.majado@carm.es
authors.forename: Maria Juliana
authors.initials: MJ
authors.lastname: Majado
authors.forename: Alfredo
authors.initials: A
authors.lastname: Minguela
authors.forename: Consuelo
authors.initials: C
authors.lastname: González-García
authors.forename: Eduardo
authors.initials: E
authors.lastname: Salido
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanquer
authors.forename: Consuelo
authors.initials: C
authors.lastname: Funes
authors.forename: Carmen Luisa
authors.initials: CL
authors.lastname: Insausti
authors.forename: Ana María
authors.initials: AM
authors.lastname: García-Hernández
authors.forename: José María
authors.initials: JM
authors.lastname: Moraleda
authors.forename: Alfonso
authors.initials: A
authors.lastname: Morales
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D001781:Blood Component Removal / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D019337:Hematologic Neoplasms / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods* / Q000592:standards; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide