Apheresis days required for harvesting CD34+ cells predicts hematopoietic recovery and survival following autologous transplantation

Bone Marrow Transplant. 2011 Dec;46(12):1519-25. doi: 10.1038/bmt.2010.336. Epub 2011 Jan 24.

Abstract

We sought to determine whether patients requiring more aphereses to obtain adequate numbers of CD34+ cells had delayed hematopoietic recovery following autologous transplantation. We identified 496 consecutive individuals with lymphoma who underwent hematopoietic stem cell mobilization using etoposide and G-CSF and first autologous transplantation. In multivariate analysis, increased apheresis days as a continuous and as a categorical variable at ≥5/<5 days significantly predicted neutrophil recovery. Apheresis days fell just short of significance (P=0.06) as a predictor of platelet recovery in multivariate analysis. Increased apheresis days (as both continuous and categorical variables) were also predictive of treatment-related myelodysplastic syndrome/AML. Patients who underwent ≥5 days of pheresis had significantly worse survival (P=0.001) than patients with less pheresis days owing to significantly higher relapse mortality (P=0.001).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD34*
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Blood Component Removal*
  • Databases, Factual
  • Disease-Free Survival
  • Etoposide / administration & dosage
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Hematopoiesis*
  • Hematopoietic Stem Cell Mobilization*
  • Hematopoietic Stem Cells*
  • Humans
  • Lymphoma* / mortality
  • Lymphoma* / therapy
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation*
  • Platelet Count
  • Recovery of Function*
  • Retrospective Studies
  • Survival Rate
  • Transplantation, Autologous

Substances

  • Antigens, CD34
  • Antineoplastic Agents, Phytogenic
  • Granulocyte Colony-Stimulating Factor
  • Etoposide