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The predictive value of white cell or CD34+ cell count in the peripheral blood for timing apheresis and maximizing yield
Author(s) -
Yu J.,
Leisenring W.,
Bensinger W.I.,
Holmberg L.A.,
Rowley S.D.
Publication year - 1999
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1999.39050442.x
Subject(s) - apheresis , cd34 , medicine , white blood cell , filgrastim , peripheral , progenitor cell , blood cell , immunology , stem cell , andrology , urology , granulocyte colony stimulating factor , chemotherapy , platelet , biology , genetics
BACKGROUND: The collection of peripheral blood stem and progenitor cells (PBPCs) for transplantation can be time‐consuming and expensive. Thus, the utility of counting CD34+ cells and white cells (WBCs) in the peripheral blood was evaluated as a predictor of CD34+ cell yield in the apheresis component. STUDY DESIGN AND METHODS: The WBC and CD34+ cell counts in the peripheral blood and the apheresis components from 216 collections were assessed. Sixty‐three patients underwent mobilization with chemotherapy plus filgrastim, and 17 patients and 14 allogeneic PBPC donors did so with filgrastim alone. The relationship between the number of WBC and CD34+ cells in the peripheral blood and in the apheresis component was analyzed by using rank correlation and linear regression analysis. RESULTS: The correlation coefficient for CD34+ cells per liter of peripheral blood with CD34+ cell yield (× 10 6 /kg) was 0.87 (n = 216 collections). This correlation existed for many patient and collection variables. However, patients with acute myeloid leukemia had fewer CD34+ cells in the apheresis component at any level of peripheral blood CD34+ cell count. Components collected from patients with CD34+ cell counts below 10 × 10 6 per L in the peripheral blood contained a median of 0.75 × 10 6 CD34+ cells per kg. When the WBC count in the blood was below 5.0 × 10 9 per L, the median number of CD34+ cells in the peripheral blood was 5.6 × 10 6 per L (range, 1.0‐15.5 × 10 6 /L). A very poor correlation was found between the WBC count in the blood and the CD34+ cell yield (p = 0.12, n = 158 collections). CONCLUSION: The number of CD34+ cells, but not WBCs, in the peripheral blood can be used as a predictor for timing of apheresis and estimating PBPC yield. This is a robust relationship not affected by a variety of patient and collection factors except the diagnosis of acute myeloid leukemia. Patients who undergo mobilization with chemotherapy and filgrastim also should undergo monitoring of peripheral blood CD34+ cell counts, beginning when the WBC count in the blood exceeds 1.0 to 5.0 × 10 9 per L.