Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation

Forty healthy adult donors underwent marrow (BM) as well as peripheral bloo d (PBSC) stem cell collections for their HLA-identical adult siblings with hematologic malignancies. BM was harvested on day 1 (target 3x10(8) nucleat ed cells/kg, 10 mu g/kg lenograstim (glycosylated G-CSF) administered on da ys 2-6, and a single leukapheresis performed on day 6, The blood volume pro cessed was the higher of 200% donor blood volume or 10 liters. The total nu cleated cell (TNC) yields from PBSC were 1.1- to 4.3-fold higher than BM (m edian 7.0 vs 3.1 x 10(8)/kg, P < 0.0001). Although BM contained a higher pr oportion of CD34(+) cells (1.3% vs 0.7%, P < 0.0001) and a comparable propo rtion of CD3(+) cells (median 29% vs 26%, P = 0.4), the absolute numbers of CD34(+) and CD3(+) cells and their subsets: were several times higher in P BSC, There was a poor correlation between BM and PBSC CD34 and TNC numbers, but a significant correlation between BM and PBSC CD3 numbers. Only five o f 40 BM harvests contained greater than or equal to 2 x 10(6) CD34(+) cells /kg compared with 35 of 40 PBSC harvests (P < 0.0001). We conclude that the numbers of progenitor and immunocompetent cells in PBSC are several times higher than in BM, It is possible to collect adequate numbers of progenitor cells from blood after lenograstim stimulation more frequently than from m arrow, and donors yielding low quantities of progenitor cells from BM usual ly deliver better quantities from PBSC.