title: A novel hematopoietic progenitor cell mobilization and collection algorithm based on preemptive CD34 enumeration.
abstract: BACKGROUND
  The collection of autologous peripheral blood (PB) stem cells can be challenging in the subgroup of patients deemed "poor mobilizers" with granulocyte-colony-stimulating factor. Plerixafor, a CXCR-4 antagonist, is an alternative mobilizing agent, but is costly, and the optimal mobilization algorithm has yet to be determined.
  
  
  METHODS
  To address the question we developed a protocol measuring PB CD34 on Day 4 of mobilization. We examined 26 patients before initiating the protocol versus 24 patients after initiation.
  
  
  RESULTS
  Significant differences (p ≤ 0.05) included fewer days of collection (1.25 days vs. 2.42 days), lower total blood volume processed (25.9 L vs. 57.2 L), lower total product volume (324 mL vs. 691 mL), lower RBC content (9 mL vs. 18 mL), and lower granulocyte percentage per collection (35% vs. 11%). There were no significant differences between the two groups in demographics, baseline platelet count, total CD34, or CD34/kg harvested.
  
  
  CONCLUSIONS
  Use of a protocol to assess PB CD34 1 day before collection allows for preemptive administration of plerixafor to augment mobilization. Subsequently, days of collection and processed blood volume are reduced while there is less RBC and granulocyte contamination in the collected stem cell product.
authors: New York Blood Center.|Department of Pathology.
authors: Emily
authors: E
authors: Storch
authors: Department of Medicine, New York-Presbyterian Hospital, New York, New York.
authors: Tomer
authors: T
authors: Mark
authors: Department of Pathology.
authors: Scott
authors: S
authors: Avecilla
authors: Department of Pathology.
authors: Carlos
authors: C
authors: Pagan
authors: Department of Medicine, New York-Presbyterian Hospital, New York, New York.
authors: Joanna
authors: J
authors: Rhodes
authors: Department of Medicine, New York-Presbyterian Hospital, New York, New York.
authors: Tsiporah
authors: T
authors: Shore
authors: Department of Medicine, New York-Presbyterian Hospital, New York, New York.
authors: Koen
authors: K
authors: van Besien
authors: Department of Pathology.
authors: Melissa
authors: M
authors: Cushing
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D018952:Antigens, CD34 / Q000097:blood*; D001596:Benzylamines; D001772:Blood Cell Count / Q000295:instrumentation; D002469:Cell Separation / Q000295:instrumentation / Q000379:methods; D002985:Clinical Protocols; D000080027:Cyclams; D004357:Drug Synergism; D004912:Erythrocytes; D005260:Female; D005434:Flow Cytometry / Q000295:instrumentation / Q000379:methods; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology; D006098:Granulocytes; D006402:Hematologic Diseases / Q000097:blood / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000097:blood / Q000628:therapy; D013997:Time Factors; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor