Peripheral blood CD34+ peak during mobilisation as an additional parameter to assess PBSC inoculum adequacy autologous HSCT
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Updated: Nov 1, 2026
Competitive Transplants to Evaluate Hematopoietic Stem Cell Fitness
Published on: August 31, 2016
Giuseppe Milone1,2, Emanuele Martorana3, Maria Grazia Camuglia2
1Istituto Oncologico del Mediterraneo, Hematopoietic Stem Cell Transplantation (HSCT) Unit-Viagrande, Viagrande, Italy.
Background:
After autologous haematopoietic stem cell transplantation (HSCT), the infused CD34+ cell dose is usually considered essential for assessing the adequacy of the peripheral blood progenitor cells (PBSC) inoculum.
Methods:
In a cohort of 302 patients who underwent autologous haematopoietic transplantation, we investigated whether the peak peripheral blood CD34+ cell count during mobilisation could predict neutrophil engraftment.
Results:
In the overall cohort, the mean time to neutrophil engraftment was 12.2 days, and the mean infused CD34+ cell dose was 5.1 × 10^6 CD34+ cells/kg. In univariate analysis, the CD34+ cell dose (p=0.005), the PB CD34+ peak during mobilisation (p=0.0002), the number of performed apheresis (p=0.03), and the use of G-CSF (p=0.001) were significantly associated with time to neutrophil engraftment. When factors were evaluated in multivariate analysis, the PB CD34+ peak and use of G-CSF remained significant. In a ROC analysis, the PB CD34+ peak predicted delayed engraftment with an AUC of 0.695 (95% CI, 0.599-0.791). Joint stratification by PB CD34+ peak and infused CD34+ dose identified subgroups at high risk of delayed engraftment.
Conclusion:
In patients treated by autologous HSCT and receiving an adequate dose of infused CD34+ cells, the PB CD34+ peak during mobilisation is independently associated with post-transplant neutrophil engraftment.
