CD34 counts to predict the adequate collection of peripheral blood progenitor cells

Abstract

An essential prerequisite for successful procurement of sufficient autologous peripheral blood progenitor cells (PBPC) for engraftment is the optimal timing of collection. A number of surrogate markers of peripheral blood progenitor cells were analysed to identify a single test which could predict the optimum time to harvest, providing at least 2 × 10⁶ CD34⁺ cells/kg patient body weight. The study comprised 95 patients undergoing varied mobilisation regimens with chemotherapy and G-CSF for both solid tumours and haematological malignancies. One hundred and fifty-seven PBPC harvests were collected. Full blood counts (FBC) and CD34⁺ cell enumeration was performed on blood samples taken during the mobilisation period and immediately prior to leucapheresis (pre-harvest). All PBPC collections were assayed for colony-forming cells and CD34⁺ cells in addition to a FBC. The white cell count on the day of harvest showed only weak correlation with the total number of CD34⁺ cells in the collection (r = 0.30). In contrast, the absolute number of circulating CD34⁺ cells strongly correlated with the CD34⁺ cell and CFU-GM yield of the corresponding apheresis product. Provided the mobilisation sample contained ⩾20 × 10⁶ CD34⁺ cells/ml, 94% of single collections, performed the following day, contained ⩾2 × 10⁶ CD34⁺ cells/kg.