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Large‐volume‐apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients
Author(s) -
Majado Maria Juliana,
Minguela Alfredo,
GonzálezGarcía Consuelo,
Salido Eduardo,
Blanquer Miguel,
Funes Consuelo,
Insausti Carmen Luisa,
GarcíaHernández Ana María,
Moraleda José María,
Morales Alfonso
Publication year - 2009
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.20191
Subject(s) - apheresis , medicine , cd34 , cyclophosphamide , urology , transplantation , progenitor cell , hematopoietic stem cell transplantation , granulocyte colony stimulating factor , leukapheresis , regimen , gastroenterology , surgery , chemotherapy , stem cell , platelet , biology , genetics
Given that pre‐apheresis CD34 + cell count (PA‐CD34) predicts the apheresis' yield, a minimum of 5 to 20 PA‐CD34/μl is required in many institutions to initiate cell collection. The aim of this study was to clarify whether large‐volume‐apheresis (LVA) could facilitate progenitor cell transplantation in patients with low PA‐CD34. Apheresis was initiated in 226 patients, disregarding PA‐CD34, at days: +5 in G‐CSF, +10 in cyclophosphamide+G‐CSF, and +15 to +20 in other chemotherapy+G‐CSF mobilization, when leucocytes >2.5 × 10 9 /L. Four times the blood volume was processed. Patients were grouped according to their PA‐CD34: ≥10/μl (group‐A, n = 143); <10/μl but ≥5/μl (group‐B, n = 40) and <5/μl (group‐C, n = 43). No differences were found in diagnoses, gender, age, previous treatments or mobilization regimen between groups. Enough CD34 + cells (>1.9 × 10 6 /kg) were obtained in 31 patients (72%) from group‐C, although in this group two mobilizations were needed in 20 patients (46.5%), compared to 5 (3.5%) and 1 (2.5%) in groups A and B, respectively ( P < 0.01). Evenly three apheresis or more were required in 28 patients (65.1%) from group‐C, compared to 8 (5.6%) and 6 (15.0%) in groups A and B, respectively ( P < 0.01). In conclusion LVA can facilitate autologous transplantation in poor‐mobilizer‐patients, low PA‐CD34 should not be an inflexible exclusion factor. J. Clin. Apheresis, 2009. © 2009 Wiley‐Liss, Inc.