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Stem Cell Analysis

An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF

Bone Marrow Transplantation volume 40, pages 925–930 (2007)Cite this article

Abstract

Increasing demand on the apheresis service makes efficient harvesting of peripheral blood stem cells (PBSCs) essential. A total of 168 adult patients with haematological malignancy were primed using low–moderate dose cyclophosphamide (1.5–3 g/m2) with G-CSF 5–10 μg/kg per day. Harvesting was booked and peripheral blood (PB) counts first checked between 6 and 10 days post-priming. One hundred and thirty (77%) patients harvested successfully (total harvest yield ⩾2 × 106 CD34+/kg) and the median PBSC collection per procedure was 2.18 × 106/kg (range 0.1–14.5). Only more lines of prior chemotherapy predicted failure to harvest in multivariate analysis (P=0.003). The PB CD34+ cell count correlated significantly with harvest yield (r=0.8448, P<0.0001). A PB CD34+ count ⩾10/μl predicted a collection of ⩾2 × 106/kg (positive-predictive value of 61%, negative-predictive-value 100%). Patients first attending day 9 required significantly fewer visits to achieve a successful harvest than those first attending days 6–8 without increasing the risk of failure. No significant difference in failure rates, number of days attending and total harvest yield was found between days 9 and 10 attendees. Collection from day 9 may however enable higher target yields to be achieved. PB CD34+ count monitoring should commence and harvesting booked from day 9 to optimize both the harvest and the efficiency of the PBSC harvesting service.

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Acknowledgements

Thanks to Phil Jenkin for assistance with data collection.

Author information

Authors and Affiliations

  1. Department of Haematology, Leeds General Infirmary, Leeds, UK

    Q A Hill & G M Smith

  2. Department of Haematology, Pinderfields General Hospital, Wakefield

    D Buxton

  3. BSBMT, UCH, London, UK

    R Pearce

  4. National Blood Service, Leeds Blood Centre, Leeds, UK

    M O Gesinde

  5. Bone Marrow Transplant Unit, St James's University Hospital, Leeds, UK

    G Cook

Authors
  1. Q A Hill
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  2. D Buxton
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  3. R Pearce
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  4. M O Gesinde
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  5. G M Smith
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  6. G Cook
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Correspondence to Q A Hill.

Additional information

Data have been presented in abstract form at the following meetings.

QA Hill, GM Smith, JA Child and G Cook. Optimal timing of autologous peripheral blood stem cell harvest following priming with cyclophosphamide and G-CSF: significant improvement in outcome harvesting day 9 compared with days 6, 7, 8 or 10. Haematologica, 90(Suppl 2), June 2005, Abstract No. 0487. (Poster presentation: EHA, Stockholm, Sweden, 2005.)

QA Hill, GM Smith, JA Child and G Cook. Optimal timing of autologous peripheral blood stem cell harvest following priming with cyclophosphamide and G-CSF: significant improvement in progenitor cell yield harvesting on day 9–10 compared with day 7–8. British Journal of Haematology, 129(Suppl 1), April 2005, Abstract No. 114. (Poster presentation: BSH, Manchester, 2005.)

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Hill, Q., Buxton, D., Pearce, R. et al. An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF. Bone Marrow Transplant 40, 925–930 (2007). https://doi.org/10.1038/sj.bmt.1705847

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