An evaluation of predictive factors for CD34+ cell harvest yields from patients mobilized with chemotherapy and growth factors.

摘要

BACKGROUND: Accurately predicting the outcomes of peripheral blood stem cell harvests is important because unproductive collections are expensive and subject the donor to unnecessary toxicity. STUDY DESIGN AND METHODS: Predictive factors for stem cell mobilization and collection by a retrospective review of 104 consecutive donors were evaluated. RESULTS: Of several previously suggested measures, the peripheral CD34+ cell concentration on the day of harvest (pCD34DH) correlated best with total numbers of CD34+ collected (r = 0.88). This was followed by the pCD34 on the day before harvest (pCD34Day -1) (r = 0.74). The peripheral WBC count on the day of harvest (pWBC) was inferior (r = 0.39). When ratios of potential predictive factors divided by the previous day's value were examined, pWBC ratio was found to be a significant independent predictive factor for cells collected (r = 0.45). Furthermore, the predictive value of both the pCD34Day -1 and the pWBC can be improved by combining with the pWBC ratio.To examine whether the chosen collection starting days were optimal, serial pCD34 obtained daily during the harvest procedures was examined. Poorly mobilizing donors, who required several days of collection, did not reach maximal harvest yields until the fourth collection day. CONCLUSIONS: pCD34DH is the optimal predictive factor for harvest yields. If pCD34DH is not available, pCD34Day -1 or pWBC combined with the pWBC ratio may offer the best prediction of harvest outcomes. The best harvest yields on poorly mobilizing donors occur 3 to 4 days after the usual collection starting times.