Inverse relationship between patient peripheral blood CD34+ cell counts and collection efficiency for CD34+ cells in two automated leukapheresis systems |
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Authors: | Heuft H G Dubiel M Rick O Kingreen D Serke S Schwella N |
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Affiliation: | Blood Bank and Division of Hematology/Oncology, Department of Internal Medicine, Charité University Hospital/Virchow Clinic, Humboldt University, Berlin, Germany. heuft.hans-gert@mh-hannover.de |
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Abstract: | BACKGROUND: The purpose of this study was to analyze the CD34 cell collection efficiency (CE) of automated leukapheresis protocols of two blood cell separators (Spectra, COBE [AutoPBSC protocol] and AS104, Fresenius [PBSC-Lym, protocol]) for peripheral blood progenitor cell (PBPC) harvest in patients with malignant diseases. STUDY DESIGN AND METHODS: PBPCs were collected by the Spectra AutoPBSC protocol in 95 patients (123 collections) and the AS104 PBSC-Lym protocol in 87 patients (115 harvests). Patients underwent a median of one (range, 1-4) conventional-volume apheresis procedure of 10.8 L (9.0-13.9) to obtain a target cell dose of > or =2.5 x 10(6) CD34+ cells per kg. RESULTS: The median overall CD34 CE was significantly better on the AS104 than on the Spectra: 55.8 percent versus 42.4 percent (p = 0.000). This was also true below (59.2% vs. 50.1%; p = 0.022) and above (51.2% vs. 41.3%; p = 0.001) the preleukapheresis threshold of 40 CD34+ cells per microL needed to collect a single-apheresis autograft. However, at > or =40 circulating CD34+ cells per microL, both cell separators achieved the target of > or =2.5 x 10(6) CD34+ cells per kg. The CD34 CE dropped significantly, from 59.2 percent at <40 cells per microL to 51.2 percent at > or =40 cells per microL on the AS104 (p = 0.017) and from 50.1 percent to 41.3 percent on the Spectra (p = 0.033). CONCLUSION: Whereas the CD34 CE was significantly different with the AS104 and the Spectra, the CD34 CE of both machines correlated inversely with peripheral blood CD34+ cell counts, showing a significant decline with increasing numbers of circulating CD34+ cells. Nevertheless, at > or 40 preapheresis CD34+ cells per microL, sufficient hematopoietic autografts of > or =2.5 x 10(6) CD34+ cells per kg were harvested by a single conventional-volume (11 L) leukapheresis on both cell separators. |
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Keywords: | AML = acute myelocytic leukemia BC = breast cancer CD34 CE = the CE of CD34+ cells CE = collection efficiency CPM = cyclophosphamide 2‐4 g/m2 DexaBEAM = dexamethasone 120 mg, carmustine 60 mg/m2, etoposide 300 mg/m2, cytarabine 800 mg/m2, melphalan 30 mg/m2 GCC = germ cell cancer HD = Hodgkin's disease MM = multiple myeloma NHL = non‐Hodgkin's lymphoma PB = peripheral blood PBPC(s) = peripheral blood progenitor cell(s) TI = paclitaxel 175 mg/m2, ifosfamide 5 g/m2 VIP‐E = etoposide 500 mg/m2, ifosfamide 4 g/m2, cisplatinum 50 mg/m2, epidoxorubicin 50 mg/m2 |
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