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CD34⁺ collection efficiency as a function of blood volumes processed in pediatric autologous peripheral blood stem
Leonid Dubrovsky1, Edward C C Wong, Evelio Perez-Albuerne
1Division of Bone Marrow Transplantation, Children's National Medical Center, Center for Cancer and Blood Disorders, Washington, DC 20010, USA. Ldubrovs@cnmc.org
Insights
Processing larger blood volumes during pediatric autologous peripheral blood stem cell (PBSC) collection does not reduce CD34(+) cell collection efficiency. This suggests sustained stem cell mobilization in children undergoing apheresis for neuroblastoma and CNS tumors.
Area of Science:
- Pediatric Hematology
- Stem Cell Transplantation
- Oncology
Background:
- Autologous peripheral blood stem cell (PBSC) collection is crucial for treating pediatric cancers like neuroblastoma and CNS tumors.
- Optimizing CD34(+) cell collection efficiency is vital for successful engraftment post-transplant.
- Understanding the impact of blood volume processed on collection efficiency is key for refining apheresis protocols.
Purpose of the Study:
- To investigate the relationship between blood volumes processed and CD34(+) collection efficiency in pediatric patients undergoing autologous PBSC collection.
- To determine if processing larger blood volumes affects the efficiency of collecting CD34(+) cells in pediatric oncology patients.
Main Methods:
- Retrospective analysis of 79 pediatric patients undergoing autologous PBSC harvest between 2001-2009.
- Categorization of harvests into standard (0-2.9 BV), large (3-6 BV), and ultra-large (>6 BV) volumes.
- Evaluation of CD34(+) collection efficiency, diagnosis, disease status, mobilization, G-CSF dose, and apheresis complications.
Main Results:
- CD34(+) collection efficiencies remained consistent across standard, large, and ultra-large blood volumes processed for both neuroblastoma and non-neuroblastoma patient groups.
- No significant differences were observed in weight, G-CSF dose, mobilization type, or apheresis complications relative to blood volume processed.
- Specific efficiencies noted: Neuroblastoma (67%, 50%, 53%) and Non-neuroblastoma (63%, 55%, 65%) for increasing blood volumes.
Conclusions:
- Processing higher blood volumes during the initial day of pediatric autologous PBSC collection does not negatively impact CD34(+) collection efficiency.
- Results suggest sustained bone marrow CD34(+) cell mobilization throughout longer apheresis procedures in pediatric patients.
- This finding supports the feasibility of extended apheresis protocols to maximize stem cell yield in pediatric oncology.
Purpose:
To characterize the relationship between CD34(+) collection efficiency and blood volumes processed in pediatric patients undergoing autologous peripheral blood stem cell (PBSC) collection.
Methods:
Retrospective 8-year (2001-2009) study of pediatric patients (n = 79) with neuroblastoma and central nervous system (CNS) tumors undergoing first day of autologous PBSC harvest using MNC program on the COBE Spectra (Caridian BCT, Lakewood, CO) was performed. Patients undergoing 0 to 2.9 BV (standard volume), 3 to 6 BV (large volume), and greater than 6 BV (ultra large volume) harvests were evaluated for CD34(+) collection efficiency, diagnosis (neuroblastoma vs. nonneuroblastoma), disease type (primary vs. relapse), mobilization regimen, granulocyte colony stimulating factor (GCSF) dose, and apheresis complications.
Results:
CD34(+) collection efficiencies (CE) for neuroblastoma patients were 67%, 50%, and 53% for standard (n = 14), large (n = 9), and ultra large (n = 5) volume harvests, respectively. Similarly, patients with nonneuroblastoma diagnoses had CD34(+) CE of 63%, 55%, and 65% for low (n = 19), large (n = 27), and ultra large (n = 5) volume harvests, respectively. Weight, granulocyte colony stimulating factor (G-CSF) stimulation, type of mobilization, and apheresis complications (normalized by run time) were similar between the standard, large, and ultra large volume groups in patients with either neuroblastoma or nonneuroblastoma diagnoses.
Conclusions:
CD34(+) collection efficiency in pediatric autologous PBSC collection on the first day of harvest does not decrease with higher numbers of blood volumes processed in patients with either neuroblastoma or nonneuroblastoma primary disease. These results indirectly indicate bone marrow CD34(+) cell mobilization occurs with longer apheresis procedures in pediatric patients.
