Basal CD34 + Cell Count Predicts Peripheral Blood Stem Cell Mobilization in Healthy Donors after Administration of Granulocyte Colony–Stimulating Factor: A Longitudinal, Prospective, Observational, Single-Center, Cohort Study

Abstract

A longitudinal, prospective, observational, single-center, cohort study on healthy donors (HDs) was designed to identify predictors of CD34 + cells on day 5 with emphasis on the predictive value of the basal CD34 + cell count. As potential predictors of mobilization, age, sex, body weight, height, blood volume as well as white blood cell count, peripheral blood (PB) mononuclear cells, platelet count, hematocrit, and hemoglobin levels were considered. Two different evaluations of CD34 + cell counts were determined for each donor: baseline (before granulocyte colony-stimulating factor [G-CSF] administration) and in PB after G-CSF administration on the morning of the fifth day (day 5). A total of 128 consecutive HDs (66 males) with a median age of 43 years were enrolled. CD34 + levels on day 5 displayed a non-normal distribution, with a median value of 75.5 cells/ μL. To account for the non-normal distribution of the dependent variable, a quantile regression analysis to predict CD34 + on day 5 using the baseline value of CD34 + as the key predictor was performed. On crude analysis, a baseline value of CD34 + ranging from .5 cells/μL to 1 cells/μL predicts a median value of 50 cells/μL on day 5; a value of 2 cells/μL predicts a median value of 70.7 cells/μL; a value of 3 cells/μL to 4 cells/μL predicts a median value of 91.3 cells/μL, and a value ≥ 5 predicts a median value of 112 cells/μL. In conclusion, the baseline PB CD34 + cell count correlates with the effectiveness of allogeneic PB stem cell mobilization and could be useful to plan the collection.

Safety and efficacy of plerixafor dose escalation for the mobilization of CD34 + hematopoietic progenitor cells in patients with sickle cell disease: interim results

“…Peak ANC ( P =0.03) and WBC count ( P =0.05), but not CD34 + cell count ( P =0.65), increased with increasing dose level. As previously reported in healthy donors, 13 , 30 , 31 there was a strong correlation of peak CD34 + count with baseline CD34 + concentration (Kendall tau=0.68, P =0.0006) but no correlation was observed with baseline ANC (Kendall tau=0.09, P =0.66) or baseline WBC count (Kendall tau=0.13, P =0.49) ( Figure 2 ). There was also no correlation, as previously reported, 13 with baseline platelet count (Kendall tau=0.30, P =0.13) or donor age (Kendall tau=0.14, P =0.49).…”

“…4 However, we also observed a strong correlation between baseline CD34 + and peak CD34 + concentrations, as previously reported with both G-CSF and plerixafor mobilization in healthy donors (Kendall tau=0.68, P =0.0006). 13 , 30 , 31 Factors contributing to baseline CD34 count remain unclear, but our data and others’ suggest that baseline CD34 + concentration may be affected by hydroxyurea-related myelosuppression. 24 , 33 Patient #8, a subject re-enrolled in the study, was particularly instructive regarding this hypothesis.…”

Challenge to Predict Mobilized Peripheral Blood Stem Cells on the Fourth Day of Granulocyte Colony-Stimulating Factor Treatment in Healthy Donors: Predictive Value of Basal CD34+ Cell and Platelet Counts

“…This study was a longitudinal, prospective, observational, single-center cohort study. One hundred twenty-two consecutive siblings, white HDs, were referred to the Transplant Program of the Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli" of Reggio Calabria (Italy), in which 111 (91%) were from the cohort of the previous study [27] and 11 (9%) were new cases. HDs received a subcutaneous injection of G-CSF, lenograstim, once daily in the morning at a dose of 10 mg/kg BW.…”

“…Recently, our clinical study described a graphic algorithm (independent of age, sex, blood volume [BV], and BW) by which it is possible to predict CD34 + mobilization on day 5 using baseline CD34 + values [27]. Herein we designed a longitudinal, prospective, observational, single-center cohort study aimed at testing whether the baseline PB CD34 + cell count is also able to predict the effectiveness of allogeneic PBSC mobilization as soon as day 4.…”

Factors predicting peripheral blood progenitor cell mobilization in healthy donors in the era of related alternative donors: Experience from a single center

“…Thus, in an attempt to make up for poor mobilization results, total blood to be processed is significantly higher in donors with poor mobilization. Other strategies for predicting poor mobilization results are currently being explored by other groups, such as the evaluation of circulating CD34+ cell basal levels before mobilization as a predictor of mobilization effectiveness . More complex approaches could include the search of single nucleotide polymorphisms involved on mobilization and the study of the G‐CSF receptor.…”