Circulating CD34+ cell counts as predictive parameter for the efficacy of peripheral stem cell apheresis in Ewing...

The parameters used by different centers for starting peripheral stem cell apheresis following mobilization with chemotherapy and G-CSF are diverse. We retrospectively analysed 62 leukaphereses performed on eleven patients with Ewing Tumors and one patient with Synovial Sarcoma, all after treatment with standardized chemotherapy (according to the EICESS protocol) and subsequent administration of G-CSF. Blood samples, drawn before the apheresis and samples of the apheresis products were analysed by flow cytometry for their content of CD34+ cells, furthermore, the peripheral leukocyte count was determined. Our aim was to define a parameter that reliably predicts the efficacy of leukapheresis in these patients. We found a significant correlation (r = 0.85; p < 0.0001) between the absolute CD34 positive cell count prior to leukapheresis and the yield of CD34+ cells/kg body weight (bw) in the apheresis product. No correlation was observed between the leukocyte count prior to apheresis and CD34+ cells/kg bw in the apheresis product (r = 0.14; p < 0.28). In addition, we found no correlation between the number of CFU-GM in the apheresis product and the CD34+ cells/kg bw (r = 0.22; p < 0.35). Our data indicate that the peripheral CD34 positive cell count prior to leukapheresis is the best parameter for predicting the efficacy of peripheral stem cell apheresis in Ewing Tumor patients after treatment with standardized chemotherapy.