Apheresis days required for harvesting CD34+ cells predicts hematopoietic recovery and survival following autologous transplantation.
We sought to determine whether patients requiring more aphereses to obtain adequate numbers of CD34+ cells had delayed hematopoietic recovery following autologous transplantation. We identified 496 consecutive individuals with lymphoma who underwent hematopoietic stem cell mobilization using etoposide and G-CSF and first autologous transplantation. In multivariate analysis, increased apheresis days as a continuous and as a categorical variable at ≥5/<5 days significantly predicted neutrophil recovery. Apheresis days fell just short of significance (P=0.06) as a predictor of platelet recovery in multivariate analysis. Increased apheresis days (as both continuous and categorical variables) were also predictive of treatment-related myelodysplastic syndrome/AML. Patients who underwent ≥5 days of pheresis had significantly worse survival (P=0.001) than patients with less pheresis days owing to significantly higher relapse mortality (P=0.001).
Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
S
S
Malik
B
B
Bolwell
L
L
Rybicki
O
O
Copelan
H
H
Duong
R
R
Dean
R
R
Sobecks
M
M
Kalaycio
J
J
Sweetenham
B
B
Pohlman
S
S
Andresen
S
S
Tench
A
A
Koo
P
P
Figueroa
E
E
Copelan
D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D001781:Blood Component Removal; D016208:Databases, Factual; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006410:Hematopoiesis; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D010976:Platelet Count; D020127:Recovery of Function; D012189:Retrospective Studies; D015996:Survival Rate; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D000972:Antineoplastic Agents, Phytogenic; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide