Platelet Count before Peripheral Blood Stem Cell Mobilization Is Associated with the Need for Plerixafor But Not with the Collection Result

Baertsch, Marc‐Andrea; Kriegsmann, Katharina; Pavel, Petra; Brückner, Thomas; Hundemer, Michael; Kriegsmann, Mark; Ho, Anthony D.; Goldschmidt, Hartmut; Wuchter, Patrick

doi:10.1159/000478911

Cited by 15 publications

(14 citation statements)

References 30 publications

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“…Moreover, the algorithm appears to be more robust and more strongly correlated with the basal Plt count. The Plt count before PBSC mobilization has repeatedly been identified as a risk factor for poor mobilization in the autologous transplant setting, and the definition of a baseline Plt concentration [37,38] threshold may be used as a predictive factor of successful mobilization with plerixafor [39]. No such data exist for allogeneic donors.…”

Section: Discussionmentioning

confidence: 99%

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

Martino

Gori

Moscato

et al. 2019

Biology of Blood and Marrow Transplantation

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, prospective, observational, single-center cohort study on healthy donors was designed to identify predictors of CD34 + cell mobilization on day 4 after granulocyte colony-stimulating factor (G-CSF) administration. As potential predictors of mobilization, age, sex, body weight, height, blood volume, WBC count, peripheral blood (PB) mononuclear cell count, platelet (Plt) count, and hematocrit and hemoglobin levels were considered. Two different evaluations of CD34 + cell counts were determined for each donor: baseline (before G-CSF administration) and in PB on day 4 after G-CSF administration. One hundred twenty-two consecutive healthy donors with a median age of 47.5 years were enrolled. The median value of CD34 + on day 4 was 43 cells/mL (interquartile range, 23 to 68), and 81.1% of donors had 20 cells/mL. Basal WBC count, Plt count, and CD34 + were significantly higher for the subjects with CD34 + levels over median values on day 4. A multivariate quartile regression analysis, adjusted by sex, age, basal CD34 + , and basal Plt count, showed a progressively stronger relationship between baseline CD34 + and Plt levels and the CD34 + levels on day 4. The basal CD34 + cutoff level to predict the levels of CD34 + on day 4 was either 2 cells/mL or 3 cells/mL and that of basal Plt count was 229 £ 10 9 /L or 230 £ 10 9 /L, respectively, to determine whether mobilization therapy should or should not be attempted. PB stem cell mobilization with G-CSF was highly effective on day 4, and herein we describe a model for predicting the probability of performing PB stem cell collection after a short course of G-CSF.

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Section: Discussionmentioning

confidence: 99%

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

Martino

Gori

Moscato

et al. 2019

Biology of Blood and Marrow Transplantation

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“…Pre‐harvest donor Hb independently correlated with CD34 count per kg of recipient body weight. Pre harvest Hb has been associated with successful stem cell collection in patients undergoing stem cell harvest prior to autologous stem cell transplantation but never in donors of allogeneic haemopoietic stem cells. Correction of donor anaemia is relevant to minimise post harvest anaemia and selection of donors with higher Hb may improve efficacy of stem cell collection.…”

Section: Discussionmentioning

confidence: 99%

Pre‐ and post‐bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender

Getta

Tong

Deren

et al. 2020

Internal Medicine Journal

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Background Donor safety is paramount when performing bone marrow stem cell harvest. The incidence of full blood count (FBC) abnormalities among donors and variables associated with anaemia after marrow harvest are not well established. Aims To describe the frequency of FBC abnormalities prior to bone marrow stem cell harvest and to identify variables associated with post harvest anaemia. Methods Outcomes of 80 consecutive adult marrow harvests performed at our centre were analysed retrospectively. Results FBC abnormalities were present in 28% of donors prior to marrow harvest with normocytic anaemia the most common abnormality in 13%. Reduced donor haemoglobin (Hb) was independently correlated with lower CD34+ cell count per kg of recipient body weight. Anaemia (Hb < 100 g/L) was seen in 20% of donors after harvest with median decrease in Hb of 19 g/L. Variables independently associated with anaemia after harvest included donor to recipient weight ratio (P = 0.011), high collection volume (P = 0.044) and female gender (P = 0.023). Total nucleated cell and CD34 concentration in the final collected product were associated with the inverse of harvested marrow volume (P < 0.001). Conclusions Pre‐harvest anaemia should be corrected where possible particularly in female donors. Marrow collection volume should be minimised to reduce post‐harvest anaemia, optimise CD34+ cell number and improve nucleated and stem cell concentrations in the harvest product.

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“…Many centers collect up to 3 adequate PBSC grafts for transplantation-eligible patients with MM in first-line therapy. This stem cell graft may be valuable even after many years, given that a mobilization approach in case of relapse can be cumbersome [14]. As a matter of fact, the use of HD-CHT and ABSCT in cases of relapse may decline in the coming years with the advent of novel therapies for MM, including CAR-T cells and daratumumab.…”

Section: Introductionmentioning

confidence: 99%

Collection, Cryostorage, Transplantation, and Disposal of Hematopoietic Stem Cell Products

Kriegsmann

Wack

Pavel³

et al. 2019

Biology of Blood and Marrow Transplantation

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Many transplantation centers routinely collect 1 or more autologous peripheral blood stem cell (PBSC) grafts in patients with hemato-oncologic and autoimmune disorders. However, subsequent high-dose chemotherapy and autologous blood stem cell transplantation (ABSCT) are often not performed, for various reasons. Currently, little is known about the actual utilization rate of stored PBSCs. We retrospectively analyzed the collection, storage, and disposal practices of PBSC products from a large cohort of patients (n = 1020) with hematologic, oncologic, and autoimmune disorders at our institution over a 12-year period. Patients with multiple myeloma were excluded. Based on our institution-specific charges, we estimated the costs for PBSC collection/processing and storage. The median number of sufficient PBSC collections per patient in the whole cohort was 2 (range, 1 to 6). We could demonstrate that only 67% of all patients who had collected sufficient PBSCs for transplantation actually underwent ABSCT, and only a small minority of all patients (4%) underwent multiple ABSCTs. The actual use of the stored PBSC grafts varied among disease entities from >80% to 0%. From a retrospective standpoint, the collected and discarded (definitively not used) or stored (potentially not used) cryostored PBSCs were associated with considerable costs of collection, cryopreservation, and long-term cryostorage. Although keeping open the therapeutic option for future transplantations may be important, there is currently a huge discrepancy between collection/storage practices and actual utilization of the cryopreserved PBSCs, at a considerable cost and strain on patients. Our study provides a rationale for reevaluating the present standards.

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Platelet Count before Peripheral Blood Stem Cell Mobilization Is Associated with the Need for Plerixafor But Not with the Collection Result

Cited by 15 publications

References 30 publications

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

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

Pre‐ and post‐bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender

Collection, Cryostorage, Transplantation, and Disposal of Hematopoietic Stem Cell Products

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