Optimization of the yield of PBSC for autotransplantation mobilized by high-dose chemotherapy and G-CSF: proposal for a mathematical model

Bone Marrow Transplant. 1994 Aug;14(2):273-8.

Abstract

We analyzed the results of 71 leukapheresis procedures performed in 21 patients to identify the best predictive factors affecting the yield of peripheral blood progenitors after high-dose chemotherapy followed by G-CSF administration. An average of 1 +/- 1 x 10(8) MNC/kg, 5 +/- 6 x 10(4) CFU-GM/kg and 4 +/- 6 x 10(6) CD34+ cells/kg was collected for each leukapheresis. When we defined > or = 5 x 10(4)/kg as the minimum number of CFU-GM per procedure for a 'satisfactory' collection, multiparameter analysis of clinical features and laboratory findings showed that the only factors that predicted the numbers of CFU-GM collected were prior treatment with the MOPP regimen and the number of mononuclear cells identified in the basophil channel of the H*1 = Technicon. A logistic regression analysis performed to generate a mathematical model revealed four predictive factors: the number of previous cycles of chemotherapy, previous MOPP chemotherapy, the interval from latest chemotherapy and the number of mononuclear cells/microliter. This model was valuable in defining the optimal time for the first leukapheresis procedure. In contrast, the number of circulating CD34+ cells did not correlate with CFU-GM numbers collected whereas the numbers of mononuclear cells did provide a simple and reliable index. Thus the principal factor affecting the efficiency of peripheral blood stem cell collection was prior therapy with MOPP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cell Separation
  • Female
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Leukapheresis
  • Male
  • Mathematics
  • Mechlorethamine / administration & dosage
  • Middle Aged
  • Models, Biological
  • Prednisone / administration & dosage
  • Procarbazine / administration & dosage
  • Retrospective Studies
  • Transplantation, Autologous
  • Vincristine / administration & dosage

Substances

  • Granulocyte Colony-Stimulating Factor
  • Procarbazine
  • Mechlorethamine
  • Vincristine
  • Prednisone

Supplementary concepts

  • MOPP protocol