Relationship of CD34+ cell dose to early and late hematopoiesis following autologous peripheral blood stem cell transplantation

Abstract

Summary:unstimulated peripheral blood contains less than one tenth the number of progenitors as marrow, the total number present in mobilized leukapheresis harvests and infused We evaluated early and late hematopoietic reconstitution in 27 patients with advanced lymphoma, Hodgto reconstitute hematopoiesis may exceed marrow by several fold. 2,3 kin's disease, and breast or ovarian cancer after treatment using high-dose/myeloablative conditioning Clinical studies have shown that 'mobilized' PBSC transplants are associated with earlier hematologic recovregimens and autologous peripheral blood stem cell (PBSC) transplantation. Eighteen patients (67%) ery, fewer complications, and reduced usage of blood components during the post-transplant period. 4-8 Methods received G-CSF 5 g/kg/day following chemotherapy and nine (33%) were mobilized using G-CSF alone.successfully used to augment PBSC levels include collecting the cells shortly after recovery from chemotherapy, 9 Each patient had 7 ؋ 10 8 mononuclear cells (MNC) per kg collected. G-CSF was administered post-PBSC after the administration of hematopoietic growth factors such as granulocyte-macrophage colony-stimulating factor infusion. While all patients showed prompt granulocyte recovery by day 14, platelet recovery failed to occur in (GM-CSF) or granulocyte colony-stimulating factor (G-CSF) 6,10,11 alone, or in combination with chemofour (15%) heavily pretreated patients with non-Hodgkin's lymphoma. Retrospective analysis in 17 patients therapy. [12][13][14][15][16] We report our experience regarding the effectiveness of revealed that the infused number of CD34 surface antigen-positive cells correlated with time to granulocyte (r G-CSF-mobilized PBSC as a source of progenitors in patients with advanced lymphomas and breast or ovarian = 0.59, P = 0.012) and platelet (r = 0.58, P = 0.021) recovery. Patients receiving the higher numbers of CD34 + cancer who received high-dose/myeloablative conditioning regimens. We have examined the relationship between stem cells had consistently better hematologic parameters at all times examined. At 180 days post-transplant, the cell yield and both early engraftment and late hematopoietic reconstitution, and the clinical factors associated with the median Hb level was 124 g/l vs 88 g/l (P = 0.004); platelet count was 202 ؋ 10 9 /l vs 25 ؋ 10 9 /l (P = 0.004); and neufailure of platelet engraftment in several patients that we treated. trophil count was 3100 ؋ 10 6 /l vs 1400 ؋ 10 6 /l (P = 0.15). Hemoglobin strongly correlated with the CD34 + cell dose at 360 days (r = 0.90, P = 0.01). We conclude that graft CD34 + cell content appears to be an indicator Patients and methods of the quality of late as well as early hematopoietic function.

CD34+/CD41a+ cells best predict platelet recovery after autologous peripheral blood stem cell transplantation

“…[7][8][9]12,13,16 The optimal number of CD34 + cells for rapid and consistent engraftment in PBSCT is 5.0 ϫ 10 6 /kg. 12 In the present study, the correlation between the number of CD34 + cells and platelet recovery was not significant (r = Ϫ0.27), in contrast to previous reports.…”

“…[7][8][9] As for platelet recovery, few studies have been reported; some have shown that the number of CFU-GM and CD34 + cells correlate with platelet recovery, 7-14 but others have not shown a significant correlation. 15,16 Recently, specific markers for megakaryocyte progenitors such as colony-forming unit megakaryocyte (CFU-MK) and CD34 + /CD41 + or CD34 + /CD61 + cells have predicted platelet engraftment in PBSCT.…”

Immature granulocyte fraction in the peripheral blood is a practical indicator for mobilization of CD34+ cells

“…Apheresis failures can be reduced if reliable indicators are available for measuring adequate mobilization of CD34 + cells. The WBC count during the recovery phase following the chemotherapy-induced nadir is widely used as the practical indicator of time to initiate apheresis, but the counts do not correlate well with the number of mobilized CD34 + cells [18][19][20]30,31]. Several previous studies reported that the rate of WBC recovery could be used to predict the most effective time for apheresis [5,9,27,32,33], but in our experience, the correlation between WBC recovery rate and the CD34 + cell number was moderate, indicating that this parameter is not useful in clinical practice.…”

“…The best time to begin PBSC collection after the chemotherapyinduced nadir without cytokine support is reported as the day of returning the WBC count to >1,000/mL [14,15], while the WBC count >3,000 or >10,000/mL is recommended when cytokine support is combined [3,16]. The correlation between the WBC count and the number of CD34 + cells in apheresis products, however, is not high, or even non-existent [8,[17][18][19][20]. Therefore, there exists a need for a good indicator that can be obtained from ordinary clinical data that will reduce the frequencies of failed apheresis.…”

G-CSF mobilized vs conventional donor lymphocytes for therapy of relapse or incomplete engraftment after allogeneic hematopoietic transplantation

“…14,15 For this reason some centers, including our own, have opted to limit the transplant infusion to that number or less for some patients. Thus for many transplant recipients, excess cells have been cryopreserved and are subsequently available for infusion.…”