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CD34+ Cell Selection

CD34+ selection of autologous peripheral blood stem cells for transplantation following sequential cycles of high-dose therapy and mobilisation in multiple myeloma

Bone Marrow Transplantation volume 25, pages 1175–1184 (2000)Cite this article

Abstract

A potential problem of autologous transplantation in the treatment of multiple myeloma (MM) is the infusion of tumor cells. CD34+ selection has been used to purge autografts in MM and it is also possible to reduce tumour cell contamination of autografts by cytotoxic drug therapy prior to peripheral blood stem cell (PBSC) collection. To evaluate the effectiveness of a protocol combining multiple cycles of high-dose therapy and CD34+ selection to reduce tumour contamination of PBSC autografts, 34 MM patients were entered on a treatment schedule comprising two sequential cycles of mobilisation, CD34+ selection, and transplantation following high-dose therapy. In the second cycle of mobilisation there was a five-fold reduction in tumour contamination of the stem cell harvest (0.5 × 106/kg) compared with the first cycle (2.5 × 106/kg). In the 97 CD34+ selection procedures performed a median of 185 × 108 mononuclear cells (MNC) were processed yielding a median of 0.98 × 108 CD34+-enriched cells. CD34+ cells were enriched 68-fold from 1.3% to 88.6%. The median yield of CD34+ cells was 42.2%. Following CD34+ selection the tumour cell contamination of the leukapheresis product was reduced by a median of 2.7 logs. This study demonstrates that in multiple myeloma a significant reduction in the malignant contamination of stem cell autografts can be achieved by combining the in vivo purging effect of cytotoxic therapy with in vitro purging by CD34+ selection. Bone Marrow Transplantation (2000) 25, 1175–1184.

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Acknowledgements

We wish to acknowledge the expert assistance of Dr T Prasad in the examination of bone marrow smears and the technical assistance of B McClure, T Rawling and J Stevens in the performance of CD34+ selection procedures. The authors wish to thank Nexell Therapeutics Inc. (Irvine, CA, USA) for the provision of the Nexell Isolex 300SA and 300i Cell Selection Systems, reagents and disposables, and for an unrestricted research grant. The authors also wish to thank Schering-Plough (Australia) for the provision of GM-CSF and for support for data management.

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Authors and Affiliations

  1. Division of Haematology, Hanson Centre for Cancer Research, Institute of Medical and Veterinary Science, Adelaide, South Australia

    PG Dyson, N Horvath, NG Van Holst, J Gibson & LB To

  2. Bone Marrow Transplant Unit, Royal Adelaide Hospital, Adelaide, South Australia

    N Horvath & LB To

  3. Institute of Haematology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia

    D Joshua, L Barrow & R Brown

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Dyson, P., Horvath, N., Joshua, D. et al. CD34+ selection of autologous peripheral blood stem cells for transplantation following sequential cycles of high-dose therapy and mobilisation in multiple myeloma. Bone Marrow Transplant 25, 1175–1184 (2000). https://doi.org/10.1038/sj.bmt.1702408

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