Roles of Peripheral Blood CD34+ Cell Count and Midpoint Collection CD34+ Cell Yield for Peripheral Blood Stem Cell Collections from Autologous Patients Mobilized by G-CSF and Plerixafor
Keywords:
Autologous peripheral blood stem cell collection, Peripheral blood CD34 cell count, Collection CD34 yield, Total blood volume, Collection efficiencyAbstract
Autologous peripheral blood stem cell transplantation is used to treat multiple hematologic malignancies including multiple myeloma, lymphomas and amyloidosis. G-CSF plus plerixafor has increasingly become a viable first-line PBSC mobilization option in the autologous patients. The aim of our study was to determine whether peripheral blood CD34+ cell count (PB CD34) or midpoint collection CD34+ yield (MPY) is a better predictor of the final collection CD34+ yield (FY) to guide decision-making to ensure collection target achievement and, when possible, to reduce collection sessions for adult autologous PBSC patients mobilized with both G-CSF and plerixafor. Eighty-eight autologous patients who were mobilized by the 2-pronged regimen underwent 171 PBSC collection sessions in 2011. Retrospective data analysis for the PBSC collections showed: (1) Both PB CD34 and MPY correlate strongly with FY; (2) Reduction of apheresis sessions in 24 patients was achieved by decision-making based on FY estimation using PB CD 34 and/ or MPY. Reduction of apheresis sessions decreases the discomfort, inconvenience, cost, and time spent associated with the stem cell collection for the patients, and also decreases the cost and increases the efficiency of our apheresis operation. Based on the prediction value of either PB CD34 or MPY, a guideline is developed for our apheresis facility for autologous PBSC patients, and 1 increased TBV is preferred at most of the time.
References
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Gratama JW, Sutherland DR, Keeney M, Papa S. Flow cytometric enumeration and immunophenotyping of hematopoietic stem and progenitor cells. J Biol Regul Homeost Agents. 2001;15(1):14-22.
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Sinha S, Gastineau D, Micallef I, et al. Predicting PBSC harvest failure using circulating CD34 levels: developing target-based cutoff points for early intervention. Bone Marrow Transplant. 2011;46(7):943-949.
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Mavroudis D, Read E, Cottler-Fox M, et al. CD34+ cell dose predicts survival, posttransplant morbidity, and rate of hematologic recovery after allogeneic marrow transplants for hematologic malignancies. Blood. 1996; 88(8):3223-3229.
Bergantim R, Trigo F, Guimarães JE. Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma. Exp Hematol Oncol. 2012;1(1):35.
Anderlini P, Przepiorka D, Seong D,et al. Clinical toxicity and laboratory effects of granulocyte-colony-stimulating factor (filgrastim) mobilization and blood stem cell apheresis from normal donors, and analysis of charges for the procedures. Transfusion. 1996;36(7):590-595.
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Weiner RS, Richman CM, Yankee RA. Semicontinuous flow centrifugation for the pheresis of immunocompetent cells and stem cells. Blood. 1977;49(3):391-397.
Reiffers J, Bernard P, David B, et al. Successful autologous transplantation with peripheral blood hemopoietic cells in a patient with acute leukemia. Exp Hematol. 1986;14(4):312-315.
Andreola G, Babic A, Rabascio C, Negri M, Martinelli G, Laszlo D. Plerixafor and Filgrastim XM02 (TevaGrastim) as a first line peripheral blood stem cell mobilisation strategy in patients with multiple myeloma and lymphoma candidated to autologous bone marrow transplantation. Eur J Haematol. 2012;88(2):154-158.
Flomenberg N, Devine SM, Dipersio JF, et al. The use of AMD3100 plus G-CSF for autologous hematopoietic progenitor cell mobilization is superior to G-CSF alone. Blood. 2005;106(5):1867-1874.
Gratama JW, Sutherland DR, Keeney M, Papa S. Flow cytometric enumeration and immunophenotyping of hematopoietic stem and progenitor cells. J Biol Regul Homeost Agents. 2001;15(1):14-22.
Sutherland DR, Keating A, Nayar R, Anania S, Stewart AK. Sensitive detection and enumeration of CD34+ cells in peripheral and cord blood by flow cytometry. Exp Hematol. 1994;22(10):1003-1010.
Sinha S, Gastineau D, Micallef I, et al. Predicting PBSC harvest failure using circulating CD34 levels: developing target-based cutoff points for early intervention. Bone Marrow Transplant. 2011;46(7):943-949.
Bender JG, To LB, Williams S, Schwartzberg LS. Defining a therapeutic dose of peripheral blood stem cells. J Hematother. 1992; 1(4):329-341.
Shpall EJ, Champlin R, Glaspy JA.Effect of CD34+ peripheral blood progenitor cell dose on hematopoietic recovery. Biol Blood Marrow Transplant. 1998;4(2):84-92
Tricot G, Jagannath S, Vesole D, et al. Peripheral blood stem cell transplants for multiple myeloma: identification of favorable variables for rapid engraftment in 225 patients. Blood. 1995; 85(2):588-596.
Wach M, Cioch M, Hus M, et al. Treatment of multiple myeloma patients with autologous stem cell transplantation - a fresh analysis. Folia Histochem Cytobiol. 2011;49(2):248-254.
Díaz MA, Garcia-Sanchez F, Lillo R, Vicent MG, Vicario JL, Madero L. Large-volume leukapheresis in pediatric patients: pre-apheresis peripheral blood CD34+ cell count predicts progenitor cell yield. Haematologica. 1999;84(1):32-35.
Fontão-Wendel R, Lazar A, Melges S, Altobeli C, Wendel S. The absolute number of circulating CD34+ cells as the best predictor of peripheral hematopoietic stem cell yield. J Hematother. 1999; 8(3):255-262.
Perez-Simón JA, Caballero MD, Corral M, et al. Minimal number of circulating CD34+ cells to ensure successful leukapheresis and engraftment in autologous peripheral blood progenitor cell transplantation. Transfusion. 1998; 38(4):385-391.
Anguita-Compagnon AT, Dibarrart MT, Palma J, et al. Mobilization and collection of peripheral blood stem cells: guidelines for blood volume to process, based on CD34-positive blood cell count in adults and children. Transplant Proc. 2010; 42(1):339-344.
Gutensohn K, Magens MM, Kuehnl P, Zeller W. Increasing the economic efficacy of peripheral blood progenitor cell collections by monitoring peripheral blood CD34+ concentrations. Transfusion. 2010;50(3):656-662.
Hester J. Peripheral blood stem cell collection: the interaction of technology, procedure, and biological factors. Transfus Sci. 2000;23(2):125-132.
Yu J, Leisenring W, Bensinger WI, Holmberg LA, Rowley SD. The predictive value of white cell or CD34+ cell count in the peripheral blood for timing apheresis and maximizing yield. Transfusion. 1999;39(5):442-450.
Lane TA, Bashey A, Carrier E, et al. Improving the efficiency of PBPC collection by pre-apheresis peripheral blood and mid-apheresis product measurements of CD34 cells. Cytotherapy. 2004;6(4):318-327.
Sidhu RS, Orsini E Jr, Giller R, et al. Midpoint CD34 measurement as a predictor of PBPC product yield in pediatric patients undergoing high-dose chemotherapy. J Clin Apher. 2006;21(3):165-168.
Fontana S, Groebli R, Leibundgut K, Pabst T, Zwicky C, Taleghani BM. Progenitor cell recruitment during individualized high-flow, very-large-volume apheresis for autologous transplantation improves collection efficiency. Transfusion. 2006; 46(8):1408-1416.
Reik RA, Noto TA, Fernandez HF. Safety of large-volume leukapheresis for collection of peripheral blood progenitor cells. J Clin Apher. 1997; 12(1):10-13.
Trickett AE, Smith S, Kwan YL. Accurate calculation of blood volume to be processed by apheresis to achieve target CD34+ cell numbers for PBPC transplantation. Cytotherapy. 2001;3(1):5-10.
Mavroudis D, Read E, Cottler-Fox M, et al. CD34+ cell dose predicts survival, posttransplant morbidity, and rate of hematologic recovery after allogeneic marrow transplants for hematologic malignancies. Blood. 1996; 88(8):3223-3229.
Bergantim R, Trigo F, Guimarães JE. Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma. Exp Hematol Oncol. 2012;1(1):35.
Anderlini P, Przepiorka D, Seong D,et al. Clinical toxicity and laboratory effects of granulocyte-colony-stimulating factor (filgrastim) mobilization and blood stem cell apheresis from normal donors, and analysis of charges for the procedures. Transfusion. 1996;36(7):590-595.
Kessans MR, Gatesman ML, Kockler DR. Plerixafor: a peripheral blood stem cell mobilizer.Pharmacotherapy. 2010; 30(5):485-492.
Mozobil (plerixafor injection) Full Prescribing Information, Genzyme Corporation. http://www.mozobil.com/document/Package_Insert.pdf. 2008.
Neupogen (filgrastim) Prescribing Information, Amgen. http://pi.amgen.com/united_states/neupogen/neupogen_pi_hcp_english.pdf. 2012. Accessed on 4/1/2013.
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Published
2013-04-29
How to Cite
Chepovetsky, J., Yoon, S. C., Blouin, A. G., Tindle, S., Bertinelli, A., Nash, E., & Wu, D. W. (2013). Roles of Peripheral Blood CD34+ Cell Count and Midpoint Collection CD34+ Cell Yield for Peripheral Blood Stem Cell Collections from Autologous Patients Mobilized by G-CSF and Plerixafor. North American Journal of Medicine and Science, 6(2). Retrieved from https://najms.com/index.php/najms/article/view/174
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