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Published on: September 6, 2017
Factors predicting peripheral blood progenitor cell collection from pediatric donors for allogeneic transplantation
Miguel A Díaz1, Julián Sevilla, Javier de la Rubia
1Spanish Group for Allogeneic Peripheral Blood Stem Cell Transplantation.
Insights
Pediatric donors mobilized with G-CSF can provide sufficient CD34+ cells for transplantation. Younger age and larger blood volume processed positively impact collection yields in pediatric peripheral blood progenitor cell (PBPC) donation.
Area of Science:
- Hematology
- Pediatric Stem Cell Transplantation
- Cellular Therapy
Background:
- Limited data exists on predictors for peripheral blood progenitor cell (PBPC) collection in pediatric donors.
- Understanding these factors is crucial for optimizing PBPC collection in children.
- Previous studies have not identified specific characteristics predicting successful PBPC collection in this population.
Purpose of the Study:
- To analyze predictive factors for successful PBPC collection in pediatric donors.
- To identify characteristics influencing CD34+ cell yield in children undergoing mobilization.
- To assess the feasibility of obtaining adequate CD34+ cell doses from pediatric donors for allogeneic transplantation.
Main Methods:
- Retrospective analysis of 105 apheresis procedures from 76 healthy pediatric donors (age 1-18 years).
- Mobilization with granulocyte colony-stimulating factor (G-CSF) at 10 microg/kg/day for 4-5 days.
- Evaluation of factors predicting a target CD34+ cell dose of >=4x10^6/Kg.
Main Results:
- Multivariate analysis revealed that total blood volume processed and apheresis day (post-first day) negatively impacted CD34+ cell yield when considering recipient body weight.
- When considering donor body weight, younger age and larger volume leukapheresis positively influenced CD34+ cell collection.
- Median CD34+ cell yield was 4.22 cells/kg recipient body weight.
Conclusions:
- Pediatric donors mobilized with G-CSF can yield sufficient CD34+ cells for allogeneic transplantation.
- Key factors influencing PBPC yield in pediatric donors include donor age, blood volume processed, and apheresis day.
- These findings support the use of pediatric donors for stem cell collection.
Background And Objectives:
Although several studies have reported on the use of children as donors for peripheral blood progenitor cells (PBPC), no specific characteristics have been identified as predictors of PBPC collection in this population. In this study we analyzed predictive factors for PBPC collection in pediatric donors.
Design And Methods:
We retrospectively analyzed factors predicting the yield for a target CD34+ cell dose of > or =4x10(6)/Kg donor or recipient body weight, in 105 aphereses from 76 healthy pediatric donors (36 boys and 40 girls) included in the Spanish National Donor Registry. Mobilization consisted of granulocyte colony-stimulating factor (G-CSF) in single doses of 10 microg/kg per day subcutaneously for 4 or 5 days. Apheresis started after the fourth dose of G-CSF.
Results:
Median age and body weight were 10 years (range 1-18) and 42 kg (range 9-89), respectively. The median number of CD34+ cells/kg recipient body weight was 4.22 (range 0.1-32). On multivariate analysis variables that had a significant negative impact on the CD34+ cell yield, considering the recipient's body weight were the total blood volume processed (regression coefficient (RC): 0.41, 95% CI: 0.21-0.81; p=0.01) and day of apheresis other than first (RC: 0.16, 95% CI: 0.07-0.34; p<0.0001). When considering donor's body weight the variables that positively influenced collection were younger age (RC: 6.79, 95% CI: 1.57-29.25; p<0.01) and large volume leukapheresis (RC: 3.33, 95% CI: 1.13-9.77; p<0.02).
Interpretation And Conclusions:
Our data suggest that pediatric donors mobilized by G-CSF may donate sufficient numbers of CD34+ cells for allogeneic transplantation. The variables that influenced the yield were the donor's age, blood volume processed and the first day of the apheresis.
