title: Decision-tree algorithm for optimized hematopoietic progenitor cell-based predictions in peripheral blood stem cell mobilization.
abstract: Enumerating hematopoietic progenitor cells (HPCs) by using an automated hematology analyzer is a rapid, inexpensive, and simple method for predicting a successful harvest compared with enumerating circulating CD34+ cells. However, the optimal HPC cutoff count and the indicating factors to be considered for improved predicting have not yet been determined.
  
  
  
  Between 2007 and 2012, a total of 189 consecutive patients who proceeded to peripheral blood stem cell (PBSC) harvesting were retrospectively recruited. Baseline characteristics were analyzed to identify the risk factors for a failed harvest, which were defined as less than 2 × 10(6) CD34+ cells/kg. Variables identified by multivariate logistic regression and correlation analysis for predicting a successful harvest were subjected to classification and regression tree (CART) analysis.
  
  
  
  PBSCs were successfully harvested in 154 (81.5%) patients. An age of at least 60 years, a diagnosis of a solid tumor, at least five prior chemotherapy cycles, prior radiotherapy, and mobilization with granulocyte-colony-stimulating factor alone or high-dose cyclophosphamide were independent baseline predictors of poor mobilization. In CART analysis, patients with zero to two host risk factors and either higher HPC (≥28 × 10(6) /L) or mononuclear cell (MNC; ≥3.5 × 10(9) /L) counts were categorized as good mobilizers and their harvest success rate was 92.3%. By contrast, 30.3% of harvests were adequate in the patients with three to five host risk factors and lower HPC and MNC counts.
  
  
  
  A CART algorithm incorporating host predictors and HPC and MNC counts improves predictions in a successful harvest and might reduce the necessity of monitoring peripheral CD34+ cells.
authors.affiliation: Division of Hematology, Department of Medicine.|Division of Medical Oncology, Department of Oncology.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chia-Yun
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Division of Hematology, Department of Medicine.|Division of Transfusion Medicine, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tzeon-Jye
authors.initials: TJ
authors.lastname: Chiou
authors.affiliation: Division of Medical Oncology, Department of Oncology.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.affiliation: Division of Hematology, Department of Medicine.|Division of Transfusion Medicine, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jeong-Shi
authors.initials: JS
authors.lastname: Lin
authors.affiliation: Division of Medical Oncology, Department of Oncology.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Man-Hsin
authors.initials: MH
authors.lastname: Hung
authors.affiliation: Division of Hematology, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Liang-Tsai
authors.initials: LT
authors.lastname: Hsiao
authors.affiliation: Division of Medical Oncology, Department of Oncology.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chueh-Chuan
authors.initials: CC
authors.lastname: Yen
authors.affiliation: Division of Hematology, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jyh-Pyng
authors.initials: JP
authors.lastname: Gau
authors.affiliation: Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hsiu-Ju
authors.initials: HJ
authors.lastname: Yen
authors.affiliation: Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Giun-Yi
authors.initials: GY
authors.lastname: Hung
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Medicine, Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Division of Hematology, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Cheng-Hwai
authors.initials: CH
authors.lastname: Tzeng
authors.affiliation: Division of Hematology, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jing-Hwang
authors.initials: JH
authors.lastname: Liu
authors.affiliation: Division of Hematology, Department of Medicine.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yuan-Bin
authors.initials: YB
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018952:Antigens, CD34 / Q000378:metabolism; D003663:Decision Trees; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000276:immunology / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000276:immunology / Q000628:therapy; D000072916:Peripheral Blood Stem Cells / Q000276:immunology / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D018952:Antigens, CD34