Baseline circulating CD34+ Cell counts predict leukapheresis yield in a diverse transplant population

Raymond L. Comenzo, Lilian Reich, Craig Moskowitz

Research output: Contribution to journalArticle

Abstract

An optimum approach to the mobilization and collection of autologous blood stem cells has not been defined. In 1999, patients at MSKCC received autologous stem cell transplant (ASCT) for a range of diagnoses: non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD), multiple myeloma (MM), acute myeloid leukemia (AML), anaplastic oligodendroglioma, and germ cell (GC) and neurectodermal (NE) malignancies. In this heavily pre-treated population, mobilization was usually with chemotherapy and G-CSF. Collections commenced on WBC recovery and the minimum collection target was 2 x 106 CD34+ cells/kg. In 1999, 36% of collections ( 187/523) yielded < 0.5 x l O6 CD34+ cells/kg and marrow harvests were needed in 10% to 15% of patients. Therefore, in an attempt to improve overall collection efficiency, we evaluated the utility of measuring baseline circulating CD34+ cell counts (BLCD34; 1SHAGE cytometrics) prior to leukapheresis and correlated baseline counts with leukapheresis yields of CD34+ cells/kg. In 42 consecutive previously uncollected patients (15NHL, 7HD, 7MM, 1AML, 3GC and 9NE), 100 consecutive leukaphereses were evaluated. Employing our standard criteria, 6 of 42 patients (14%) failed to achieve the target dose in 3 to 5 leukaphereses. BLCD34 predicted leukapheresis yield (R2=0.87, p"0.01 ) and patients with BLCD34 > 20 per ul were highly likely to achieve the target dose in a single leukapheresis (3 blood volumes). In 47% of the leukaphereses BLCD34 was equal to 0 per ul and median yield was 0 CD34+ cells/kg. If leukapheresis had not been performed for BLCD34 = 0 in all cases, 9 of 42 patients (21 %) would have failed to achieve the target dose. Therefore, the use of a BLCD34 measurement would significantly enhance overall collection efficiency if leukapheresis were not performed when BLCD34 = 0. In addition, patients requiring marrow harvest would be spared the side effects of leukapheresis.

Original languageEnglish (US)
Pages (from-to)314b
JournalBlood
Volume96
Issue number11 PART II
StatePublished - Dec 1 2000
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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