Identification of the CD34 enumeration on the day before stem cell harvest that best predicts poor mobilization

Transfusion. 2011 Mar;51(3):587-90. doi: 10.1111/j.1537-2995.2010.02891.x. Epub 2010 Sep 28.

Abstract

Background: We questioned whether CD34 enumeration in peripheral blood on the day before planned collection would identify a patient population that could benefit from an augmented collection strategy during that mobilization attempt.

Study design and methods: A retrospective review of all adult patients who underwent a first mobilization attempt between January and December 2008 for autologous use was undertaken. Peripheral blood CD34 quantitation on the day before planned collection (Day -1) and day of planned collection (Day 0) was correlated with likelihood of a successful collection.

Results: Of 41 patients (15 with multiple myeloma, 20 with lymphoma, and six with other malignancies) who underwent mobilization 24 patients (58%) were harvested in 1 day (good mobilizers) with the remaining 17 patients (42%) either requiring more than 1 day to collect or were not collected (poor mobilizers [PMs]). A peripheral blood CD34+ count below 10 × 10(6) /L on Day -1 was optimal in identifying PMs (adjusted odds ratio of 7 [1.4-35]). Increasing the CD34 cutoff from 10 × 10(6) to 15 × 10(6) /L decreased the prediction of poor mobilization (positive likelihood ratio dropped from 3.3 to 2.2).

Conclusion: Peripheral blood CD34 content of less than or equal to 10 × 10(6) CD34+ cells/L on the day before collection is predictive of poor mobilization whereas higher peripheral blood CD34 counts on Day -1 have a high likelihood of successful 1-day collection.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD34 / analysis*
  • Blood Cell Count
  • Female
  • Hematopoietic Stem Cell Mobilization*
  • Hematopoietic Stem Cell Transplantation
  • Hematopoietic Stem Cells / chemistry
  • Hematopoietic Stem Cells / cytology*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Antigens, CD34