Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

Sakashita, Araci Massami; Kondo, Andrea Tiemi; Ribeiro, Andreza Alice Feitosa; Cipolletta, Andrea Neri Folchini; Colesanti, Monica Vilela; Hamerschlak, Nelson; Kutner, Jose Mauro

doi:10.1590/S1679-45082011AO1932

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Original Article • Einstein (São Paulo) 9 (2) • Apr-Jun 2011 • https://doi.org/10.1590/S1679-45082011AO1932 copy

Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To evaluate factors affecting peripheral blood hematopoietic stem cell yield in patients undergoing large-volume leukapheresis for autologous peripheral blood stem cell collection.

Methods:

Data from 304 consecutive autologous peripheral blood stem cell donors mobilized with hematopoietic growth factor (usually G-CSF), associated or not with chemotherapy, at Hospital Israelita Albert Einstein between February 1999 and June 2010 were retrospectively analyzed. The objective was to obtain at least 2 × 10⁶ CD34+ cells/kg of body weight. Pre-mobilization factors analyzed included patient's age, gender and diagnosis. Post mobilization parameters evaluated were pre-apheresis peripheral white blood cell count, immature circulating cell count, mononuclear cell count, peripheral blood CD34+ cell count, platelet count, and hemoglobin level. The effect of pre and post-mobilization factors on hematopoietic stem cell collection yield was investigated using logistic regression analysis (univariate and multivariate approaches).

Results:

Pre-mobilization factors correlating to poor CD34 + cell yield in univariate analysis were acute myeloid leukemia (p = 0.017) and other hematological diseases (p = 0.023). Significant post-mobilization factors included peripheral blood immature circulating cells (p = 0.001), granulocytes (p = 0.002), hemoglobin level (p = 0.016), and CD34+ cell concentration (p < 0.001) in the first harvesting day. However, according to multivariate analysis, peripheral blood CD34+ cell content (p < 0.001) was the only independent factor that significantly correlated to poor hematopoietic stem cell yield.

Conclusion:

In this study, peripheral blood CD34+ cell concentration was the only factor significantly correlated to yield in patients submitted to for autologous collection.

Hematopoietic stem cells; Mobilization; Leukapheresis; Blood specimen collection/methods; Transplantation, autologous

Disease	CD34+ cells/kg body weight
Disease	≥ 2 × 10⁶	< 2 × 10⁶
Lymphoma	106 (92%)	9 (8%)
Multiple myeloma	67 (92%)	6 (8%)
Auto immune disease	36 (97%)	1 (3%)
Acute myeloid leukemia	24 (73%)	9 (27%)
Solid tumor	25 (81%)	6 (19%)
Other hematological diseases	17 (74%)	6 (26%)

Variable		OR	95%CI	p value
Patient
	Age	0.999	(0.978; 1.020)	0.899
	Female gender	0.834	(0.412; 1.691)	0.615
Diagnosis
	Lymphoma	3.057	(0.374; 24.968)	0.184
	Multiple myeloma	3.224	(0.374; 27.826)	0.287
	Acute myeloid leukemia	13.500	(1.605; 113.552)	0.017^* * A p value < 0.05 was considered statistically significant.
	Solid tumor	8.640	(0.989; 76.251)	0.052
	Other hematological diseases	12.706	(1.416; 114.004)	0.023^* * A p value < 0.05 was considered statistically significant.
Pre-apheresis data
	PB white blood cells	0.999	(0.981; 1.017)	0.890
	PB immature cells	0.839	(0.758; 0.928)	0.001^* * A p value < 0.05 was considered statistically significant.
	PB granulocyte cells	1.051	(1.019; 1.084)	0.002^* * A p value < 0.05 was considered statistically significant.
	PB mononuclear cells	0.983	(0.955; 1.013)	0.274
	PB platelet count	0.999	(0.995; 1.003)	0.734
	PB hemoglobin level	1.261	(1.045; 1.521)	0.016^* * A p value < 0.05 was considered statistically significant.
	PB CD34+ cells	0.836	(0.978; 1.020)	<0.001^* * A p value < 0.05 was considered statistically significant.

Variable		OR	95%CI	p value
Diagnosis
	Acute myeloid leukemia	0.688	(0.053; 9.020)	0.776
	Solid tumor	0.543	(0.037; 8.058)	0.657
	Otder hematological diseases	0.396	(0.026; 6.100)	0.506
Pre-apheresis data
	PB immature cells	0.998	(0.872; 1.142)	0.981
	PB granulocyte cells	1.038	(0.984; 1.096)	0.172
	PB hemoglobin level	1.240	(1.946; 1.626)	0.119
	PB CD34+ cells	0.831	(0.769; 0.897)	<0.001^* * A p- value <0.05 was considered statistically significant

Instituto Israelita de Ensino e Pesquisa Albert Einstein Avenida Albert Einstein, 627/701 , 05651-901 São Paulo - SP, Tel.: (55 11) 2151 0904 - São Paulo - SP - Brazil
E-mail: revista@einstein.br

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[1] Corresponding author: Araci Massami Sakashita – Banco de Sangue do Hospital Israelita Albert Einstein – Avenida Albert Einstein, 627, 4º andar – Morumbi – CEP 05651-901 – São Paulo (SP), Brasil – Tel.: (11) 2151-0444 – E-mail: aracims@einstein.br

Number of patients		304
Age (years)*		46 ± 16 (3-73)
Sex
	Male	176 (58%)
	Female	128 (42%)
Diagnosis
	Lymphoma	114 (38%)
	Multiple myeloma	68 (22%)
	Auto immune disease	37 (12%)
	Acute myeloid leukemia	33 (11%)
	Solid tumor	31 (10%)
	Other hematological diseases	21 (07%)
Weight (kg)^* * Mean ± standard deviation (range).		73 ± 96 (13-143)
Total blood volume (mL)^* * Mean ± standard deviation (range).		4.578 ± 1.023 (927-7.714)