Peripheral blood stem cell collection for allogeneic hematopoietic stem cell transplantation: Practical implications after 200 consequent transplants

Background

Proper stem cell mobilization is one of the most important steps in hematopoietic stem cell transplantation (HSCT). The aim of this paper is to share our 6 years’ experience and provide practical clinical approaches particularly for stem cell mobilization and collection within the series of more than 200 successive allogeneic HSCT at our transplant center.

Subjects & Methods

Two hundred and seven consecutive patients who underwent allogeneic peripheral blood stem cell transplantation were included in this study. Age, sex, weight, complete blood counts, CD34⁺ cell counts, total collected amount of CD34⁺ cells, CD34⁺ cells per 10 l processed, mobilization failure and adverse events were reviewed.

Results

Median age was 40.2 ± 12.9 (21–68) years and 46.4 ± 13.4 (17–67) years for donors and patients, respectively. The number of donors who had undergone adequate CD34⁺ cell harvesting and completed the procedure on the fourth day was 67 (32.8% of all patients). Only 12 patients required cell apheresis both on day 5 and 6. Apheresis was completed on day 4 and/or day 5 in 94.2% of all our donors. There was no significant association between CD34⁺ stem cell volume and age, gender and weight values of donors. Mobilization failure was not seen in our series.

Conclusions

G-CSF is highly effective in 1/3 of the donors on the 4th day in order to collect enough number of stem cells. We propose that peripheral stem cell collection might start on day 4th of G-CSF treatment for avoiding G-CSF related side effects and complications.