A new model for predicting the timing of leukapheresis on the basis of CD34+ cell and hematopoietic progenitor cell levels

• Published in: Journal of clinical apheresis Vol. 22; no. 4; pp. 195 - 203
• Main Authors: Teng, Hao-Wei, Hsiao, Liang-Tsai, Chaou, Shu-Chou, Gau, Jyh-Pyng, Lee, Tzu-Chi, Shih, Ying-Yih, Liu, Chun-Yu, Hong, Ying-Chung, Chen, Ming-Huang, Chang, Mu-Hsin, Yang, Ya-Hsu, Chen, Po-Min
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2007
• Subjects: Adolescent; Adult; Aged; antigens; antigens, CD34; Antigens, CD34 - analysis; CD34; Cell Count; evaluation studies; Female; Hematopoietic Stem Cells; Humans; leukapheresis; Leukapheresis - standards; Leukocytes - chemistry; Male; Middle Aged; Models, Biological; Neoplasms - drug therapy; Neoplasms - therapy; Prognosis; stem cell transplantation; Time Factors
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.20117

We developed a model (depending on peripheral CD34+ cell count and hematopoietic progenitor cell count) to determine the optimal timing of 3‐day leukapheresis in patients pretreated with chemotherapy and G‐CSF. Marrow potentials were identified on the basis of three patterns of leukapheretic yield. Pattern 1 predicted good marrow potential. The positive predictive value of a first‐day leukapheretic yield of >1 × 106 CD34+ cells/kg (mean 3‐day yield = 8.18 × 106 CD34+ cells/kg, n = 11) was 100%. Pattern 2 predicted poor marrow potential. The negative predictive value of a 3‐day leukapheretic yield of >1 × 106 CD34+ cells/kg (3‐day yield = 0.26 × 106 CD34+ cells/kg, n = 1) was 100%. Pattern 3 met neither of the above criteria (mean 3‐day yield = 1.37 × 106 CD34+ cells/kg, n = 19). The marrow potential was borderline and patients could be further divided into two subgroups according to peripheral CD34+ cell counts when WBC reached >10,000/μl. The mean yield differed significantly between pattern 1 and 3 (P < 0.001). For patients with good marrow potential, leukapheresis should begin as soon as the WBC count is >5,000/μl. Patients with borderline marrow potential may benefit from delaying leukapheresis until the WBC level is >10,000/μl and leukapheresis extended more than 3 days. J. Clin. Apheresis 2007. © 2007 Wiley‐Liss, Inc.