A multiple regression analysis on factors influencing haematopoietic progenitor cell collection for autologous transplantation

摘要

Autologous hematopoietic stem cell (HSC) transplantation today is the standard treatment for a wide variety of haematological and oncological diseases. HSC are collected from peripheral blood by leukapheresis (HPC-A) following chemotherapy and/or growth factor-mediated mobilization. The ideal HPC-A collection allows to reach the CD34+ target dose through a single, tailored leukapheresis. The aim of this paper was to find out which collection parameter might play a key role in obtaining a CD34 dose 4×106/kg with a reduced number of leukapheresis. To address this issue, a multivariate logistic regression was carried out on several operational and laboratory parameters from 943 HPC-A collections performed in 600 hematological and oncological patients. We observed a CD34+ cells collection efficiency (CE) 50% when patient's pre-apheresis total WBC count was lower than 12.5×106/mL. At the same time, the likelihood of reaching the CD34+ cells target dose/kg increased from 6 to 3 times when the pre-apheresis WBC count ×106/mL t was below 4.3 (OR=6.1; 2.6-14.1) and between 4.3 and 7 (OR=2.8; 1.4-5.7) respectively when compared to a pre-apheresis WBC count 36×106/mL.