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Preapheresis peripheral blood CD34+ mononuclear cell counts as predictors of progenitor cell yield

Authors

  • R.J. Benjamin,

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    • 1

      Richard J. Benjamin, MB, ChB, PhD, Associate Medical Director, Blood Bank, Brigham and Women's Hospital, Boston, MA.

  • L. Linsley,

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    • 3

      Leticia Linsley, BS, Research Assistant, Department of Pediatric Oncology, Dana Farber Cancer Institute, Boston, MA.

  • D. Fountain,

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    • 4

      Denise Fountain, MS, MT(ASCP)SBB, Administrative Supervisor, Blood Bank, Brigham and Women's Hospital.

  • W.H. Churchill,

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    • 5

      W. Hallowell Churchill, MD, Medical Director, Blood Bank, Department of Hematology/Oncology, Brigham and Women's Hospital; and Associate Professor of Medicine, Harvard Medical School.

  • C. Sieff,

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    • 6

      Colin Sieff, MB, ChB, Associate Professor of Pediatrics, Department of Pediatric Oncology, Dana Farber Cancer Institute.

  • M.E. Cannon,

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    • 7

      Marie E. Cannon, MD, Associate Medical Director, Blood Bank, Brigham and Women's Hospital; and Instructor, Department of Pathology, Harvard Medical School.

  • L. Uhl,

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    • 8

      Lynn Uhl, MD, Associate Medical Director, Blood Bank, Beth Israel Hospital, Boston, MA; and Instructor, Department of Pathology, Harvard Medical School.

  • L. Gaynes,

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    • 9

      Lisa Gaynes, RN, Bone Marrow Transplant Coordinator, Beth Israel Hospital.

  • J.H. Antin,

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    • 10

      Joseph H. Antin, MD, Clinical Director, Bone Marrow Transplant, Department of Hematology/Oncology, Brigham and Women's Hospital; and Associate Professor of Medicine, Harvard Medical School.

  • C. Wheeler

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    • 11

      Cathy Wheeler, MD, Clinical Director, Bone Marrow Transplant, Department of Hematology/Oncology, Beth Israel Hospital; and Assistant Professor of Medicine, Harvard Medical School.


Instructor, Department of Pathology, Harvard Medical School, 75 Francis Street, Boston, MA 02115

Abstract

BACKGROUND: Peripheral blood progenitor cells, harvested by apheresis after mobilization, provide rapid hematologic recovery after high-dose chemotherapy. However, because harvesting these cells is expensive and time-consuming, there has been much interest in optimizing collection protocols. An investigation was made to determine whether, in this clinical setting, peripheral blood progenitor cell yields may be predicted from preapheresis progenitor cell counts, allowing the length of each procedure to be “fine tuned” to achieve specific target goals.

STUDY DESIGN AND METHODS: Preapheresis peripheral blood CD34+ cell and total colony-forming cell counts were assessed before 78 peripheral blood progenitor cell collections from 13 consecutive patients were performed. Preapheresis counts were correlated with actual progenitor cell yields. Factors affecting this correlation were analyzed.

RESULTS: With the use of linear regression analysis preapheresis progenitor cell counts were found to correlate significantly but weakly with actual yields per kg of body weight per liter of blood processed (CD34+ cells: r = 0.43; colony-forming cells: r = 0.56). Further analysis revealed two possible causes: 1) circulating progenitor cell concentrations fluctuate widely during harvest, which implies that preapheresis counts are not representative of actual concentrations during apheresis, and 2) the efficiency with which apheresis machines extract mononuclear cells varies greatly between procedures.

CONCLUSION: Preapheresis CD34+ and colony-forming cell counts correlated poorly with subsequent yields in this clinical setting, which suggests that it is not practical to use such counts to predict with certainty the length of apheresis needed to achieve a target yield.

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