KINETICS OF PERIPHERAL-BLOOD MONONUCLEAR CELL MOBILIZATION WITH CHEMOTHERAPY AND OR GRANULOCYTE-COLONY-STIMULATING FACTOR - IMPLICATIONS FOR TIMING AND YIELD OF HEMATOPOIETIC PROGENITOR-CELL COLLECTIONS/

Background: Peripheral blood progenitor cells (PBPCs) are commonly col lected and used to reconstitute hematopoiesis after high-dose chemothe rapy. However, strategies for optimal collection and assessment of leu kapheresis components are not standardized. Study Design and Methods: Hematopoietic progenitor cell assays were performed on 369 leukapheres is components collected from 95 patients who had received doxorubicin- based chemotherapy and/or granulocyte-colony-stimulating factor (G-CSF ). Precollection patient hematologic values, leukapheresis collection values, component hematopoietic progenitor cell assays, and patient ou tcome measures were summarized. The kinetics of mononuclear cell (MNC) and PBPC mobilization were assessed among four patient groups. Result s: Patient group was a significant predictor of the peripheral blood M NC count on the day of collection (p<0.0001), and that value was a sig nificant predictor of granulocyte-macrophage-colony-forming unit (CFU- GM) yield (p<0.0001). This relationship between the peripheral blood M NC count on the day of collection and CFU-GM yield differed according to patient group (p<0.0001). CFU-GM made up a larger fraction of perip heral blood MNCs collected from patients who received chemotherapy plu s G-CSF than collected from those who received G-CSF alone. Moreover, the peripheral blood MNC count and the corresponding CFU-GM yield incr eased significantly on consecutive days of collection in patient group s receiving chemotherapy and G-CSF but were unchanged or decreased in patients receiving G-CSF alone. Conclusion: The relationship between p eripheral blood MNC count and leukapheresis component CFU-GM yield dif fered significantly between patients who received chemotherapy and G-C SF and those who received G-CSF alone for the mobilization of PBPCs. P atient peripheral blood MNC count and component CFU-GM yield are usefu l for both assessing and suggesting revisions to PBPC mobilization and collection strategies.