Peripheral blood progenitor cell collection without close monitoring of peripheral blood CD34+ cells: A feasible strategy for multiple myeloma or pre-treated Non-Hodgkin’s Lymphoma patients mobilized with low-dose cyclophosphamide plus G-CSF

Callera, Fernando; Cavenaghi, Luciana; Melo, Cláudio M.T.P. de

doi:10.1016/j.transci.2009.01.015

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…Despite absolute circulating CD34+ cell count being the gold standard for predicting a successful PBSC collection, the cost of CD34+ determination is still a significant concern for many patients and/or institutions. Some studies attempted to create protocols for initiating an effective PBSC collection on a fixed day [30]. Our study demonstrated that some conventional, less costly and easily obtained parameters were reliable predictors for a successful PBSC harvest.…”

Section: Discussionmentioning

confidence: 63%

Dynamics of monocyte count: A good predictor for timing of peripheral blood stem cell collection

Yang

Chen

et al. 2012

J of Clinical Apheresis

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To investigate potential predictive parameters for successful collection of autologous peripheral blood stem cells (PBSC), 60 consecutive first mobilization attempts and 145 leukapheresis procedures for patients with hematologic malignancies (multiple myeloma: n = 20; acute leukemia: n = 27; lymphoma: n = 13) were analyzed. All patients underwent chemotherapy and granulocyte-colony stimulating factor combined mobilization protocols. PBSC collection began when white blood cell (WBC) count rebounded to >1.0 × 10(9)/L. Poor mobilization (PM) was defined as <2.0 × 10(6)/kg of ideal body weight CD34+ cells were collected from at least three leukapheresis procedures. PM incidence was 15% (9/60). On the first apheresis day, CD34+ cell yield was closely associated with the final yield. Failure to reach the first-day target of 0.7 × 10(6) CD34+ cells/kg was perfectly matched with PM. Circulating WBC and monocyte (MO) counts preleukapheresis had a positive correlation with final CD34+ cell yield. For the first-day apheresis target, receiver operator characteristic (ROC) curve analysis showed that MO count had an area under the curve (AUC) of 0.806 (P = 0.004). An optimal predictive cutoff value for MO count was 1.455 × 10(9)/L with both high sensitivity and specificity of 0.739 and 0.899, respectively. Patients who began leukapheresis with an MO count of ≥1.455 × 10(9)/L accomplished more successful first-day collections than those of their counterparts (P = 0.021). ROC analysis also showed preapheresis WBC count had a high AUC of 0.768 (P = 0.012). However, we could not find a WBC indicator to initiate leukapheresis. In conclusion, circulating MO count after mobilization is a helpful parameter to determine the optimal time point for starting a PBSC collection.

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Section: Discussionmentioning

confidence: 63%

Dynamics of monocyte count: A good predictor for timing of peripheral blood stem cell collection

Yang

Chen

et al. 2012

J of Clinical Apheresis

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“…Further, peripheral blood CD341 cell enumeration does not account for variables such as patient weight, blood volume processed, and collection efficiency, which also affect the number of CD341 cells collected [23]. Some institutions may only have limited access to flow cytometry facilities and daily peripheral CD341 monitoring may be costly [25]. For these reasons, as well as practical issues of timely performance of this test, many transplant institutions do not use preapheresis blood CD341 cell count to determine when to start collection.…”

Section: Discussionmentioning

confidence: 99%

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Duong

Bolwell

Rybicki

et al. 2011

J of Clinical Apheresis

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Early and reliable prediction of the likelihood of achieving adequate stem cell collection for autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) would improve collection efficiency, prevent unnecessary aphereses, and permit appropriate treatment alterations. No previous study has reported a threshold CD34+ cell collection quantity on Day 1 or 2 of leukapheresis that could predict successful stem cell collection. We performed a retrospective analysis of all MM patients undergoing first attempt of stem cell collection at our institution from 2001 through 2008. Recursive partitioning analysis was used to identify Day 1 or Day 1+2 CD34+ collection quantity that predicted failure to reach target ≥ 2 × 10(6) CD34+ cells/kg within five days of collection. Totally, 172 patients were included in the analysis. Patients underwent mobilization with G-CSF or G-CSF+ chemotherapy. 23 of 172 patients (13.4%) failed to collect sufficient (≥ 2 × 10(6) CD34+ cells/kg) CD34+ cells after five days of apheresis: 22 of 29 who collected ≤ 0.70 × 10(6) CD34+ cells/kg and 1 of 143 who collected > 0.70 × 10(6) CD34+ cells/kg (75.9% vs. 0.7%, P < 0.001) on Day 1. Collection failure occurred in 23 of 30 patients who collected ≤ 1.54 × 10(6) CD34+ cells/kg and 0 of 142 who collected >1.54 × 10(6) CD34+ cells/kg (76.7% vs. 0%, P < 0.001) on Days 1 + 2. Day 1 CD34+ cell collection quantity identifies patients unlikely to achieve adequate collection for ASCT. Patients who collect ≤ 0.70 × 10(6) CD34+ cells/kg on day 1 could be considered for treatment modifications to improve CD34+ collection, such as early administration of plerixafor or large volume apheresis.

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“…In multiple myeloma, patients with poor collections immediately received CY pulsing to enhance yield. 39,45 These patients generally were in first partial response with only 4 months of prior induction therapy. In the lymphoma cohort, collection attempts began after proof of chemosensitive disease after relapse by using either rituximab with ifosfamide, carboplatin, and etoposide or rituximab with dexamethasone, cytarabine, and cisplatin.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

Gertz

Wolf

Micallef

et al. 2010

Bone Marrow Transplant

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Peripheral blood progenitor cell collection without close monitoring of peripheral blood CD34+ cells: A feasible strategy for multiple myeloma or pre-treated Non-Hodgkin’s Lymphoma patients mobilized with low-dose cyclophosphamide plus G-CSF

Cited by 10 publications

References 16 publications

Dynamics of monocyte count: A good predictor for timing of peripheral blood stem cell collection

Dynamics of monocyte count: A good predictor for timing of peripheral blood stem cell collection

Predicting hematopoietic stem cell mobilization failure in patients with multiple myeloma: A simple method using day 1 CD34+ cell yield

Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

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