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Immature granulocyte fraction in the peripheral blood is a practical indicator for mobilization of CD34 + cells
Author(s) -
EndoMatsubara Mari,
Ogawa Seishi,
Sasaki Ko,
Takahashi Tsuyoshi,
Chiba Shigeru,
Hirai Hisamaru
Publication year - 2004
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20193
Subject(s) - mobilization , granulocyte , peripheral blood , peripheral , cd34 , granulocyte colony stimulating factor , fraction (chemistry) , leukapheresis , medicine , immunology , chemistry , microbiology and biotechnology , biology , stem cell , chromatography , chemotherapy , political science , law
We propose a simple parameter that improves prediction of the number of CD34 + cells in blood cells collected by apheresis for autologous peripheral blood stem cell (PBSC) transplantation following administration of granulocyte colony‐stimulating factor. The percentage of immature granulocytes including myeloblasts, promyelocytes, myelocytes, and metamyelocytes (LSI for left‐shift index) immediately prior to the start of each apheresis correlated with the number of CD34 + cells in PBSC collections ( r = 0.79, P < 0.0001, Y = 0.227 X − 0.99, R 2 = 0.623) much better than did the white blood cell count ( r = 0.07), currently the most commonly used predictor in deciding the initiation of apheresis. We then used receiver operating characteristic (ROC) curves to determine a cutoff point for LSI to prevent unnecessary apheresis. At LSI > 7.5, sensitivity and specificity of cutoff points in the probability of obtaining >1.0 × 10 6 CD34 + cells/kg BW were 93.3% and 94.3% (95% CI, 91.4–100.0%), respectively. When LSI reaches 15.25, nearly 100% of apheresis will attain the target CD34 + cell dose. These findings indicate that LSI is a useful and simple method for predicting the yield of CD34 + cells before the start of PBSC collection and avoiding unnecessary apheresis. Am. J. Hematol. 77:223–228, 2004. © 2004 Wiley‐Liss, Inc.