LARGE-VOLUME APHERESIS FOR THE HARVEST OF PERIPHERAL-BLOOD PROGENITORCELLS FOR AUTOLOGOUS TRANSPLANTATION

BACKGROUND: The mobilization and harvest of a sufficient number of per ipheral blood stem and progenitor cells for autologous transplantation is an important aspect of treatment in patients with certain hematolo gic and solid tumor diseases. The level of CD34+ cells in peripheral b lood is often used as a predictor of successful harvest. STUDY DESIGN AND METHODS: A total of 129 apheresis procedures in 38 patients have b een investigated retrospectively to evaluate the possibility to predic t the outcome by other measures, such as total treated blood volume (T BV) during the apheresis. RESULTS: No significant correlation was obse rved between the level of CD34+ cells per kg of body weight in collect ed apheresis components and the TBV in all 129 apheresis procedures. H owever, analysis of results from 22 apheresis procedures with TBV > 16 L (large-volume apheresis) and with <10 x 10(3) CD34+ cells per mL in the peripheral blood found a correlation between TBV and the number o f CD34+ cells per kg of body weight in the collected component (R(2) = 0.585, p = 0.005). In patients who underwent large-volume apheresis ( >16 L) and who had <10 x 10(3) CD34+ cells per mt in their peripheral blood, the number of CD34+ cells in the apheresis component was not co rrelated with that in the peripheral blood prior to harvest (R(2) = 0. 262, p = 0.1569). In the patients who underwent apheresis procedures w ith TBV <16 L and who had >20 x 10(3) CD34+ cells per mt in their peri pheral blood, there was a correlation between the number of CD34+ cell s in the component and the number of CD34+ cells in the peripheral blo od (R(2) = 0.800, p = 0.0000). However, there was not a correlation in this group between the number of CD34+ cells in the component and the TBV. There were no significant differences in the content of CD34+/CD 33+ and CD34+/HLA-DR+ cells in the collected components in the two gro ups. CONCLUSION: TBV appears to be critical for the collection of a su fficient number of progenitor cells in patients with <10 x 10(3) CD34 cells per mL in peripheral blood.