Sabine Kayser (Mannheim / DE), Richard F. Schlenk (Heidelberg / DE), Stefan A. Klein (Mannheim / DE), Daniela Heidenreich (Mannheim / DE), Martin Hoffmann (Ludwigshafen / DE), Peter Paschka (Ludwigshafen / DE), Marcus Steiner (Mannheim / DE), Harald Klüter (Mannheim / DE), Patrick Wuchter (Mannheim / DE)
Autologous stem cell collection (ASCC) from the peripheral blood after mobilization with granulocyte-colony stimulating factor (G-CSF) remains an important option for patients with hemato-oncological diseases as part of initial therapy or at relapsed/refractory stage. We aimed to identify factors predictive of successful CD34+ ASCC.
We retrospectively evaluated 255 patients who underwent an ASCC (median age 60.5 years, range 7.5-74 years) at our institution from 2017 to 2023. The predicted minimal number of CD34+ cells to be collected was calculated as follows: [(peripheral CD34+ cells/µL) × adjusted collection efficiency of 30%] × total liters processed per kg body weight (bw).
229 patients had hematological diseases (multiple myeloma (MM), n=115; non-Hodgkin"s lymphoma (NHL), n=102; Hodgkin's lymphoma (HL), n=11; amyloidosis, n=1), 15 patients had germ-line tumors, 8 had Ewing"s sarcoma, and 3 had multiple sclerosis. 159 patients were of male gender.
Overall, 333 ASCC were performed. In 78 patients (31%) more than 1 apheresis session was necessary to reach the collection goal (range 2-4). In addition to G-CSF, the CXCR4-antagonist plerixafor was given in 24 patients (9%) (MM and NHL, n=9, each; germ-line tumor, n=3; HL, n=2; Ewing"s sarcoma, n=1).
Total CD34+ collection was in median 6.6 × 106 CD34+ cells/kg bw (range, 0.2-62.7), 3.5 × 106 CD34+ cells/kg bw (range, 0.6-14.4), 3.2 × 106 CD34+ cells/kg bw (range, 0.3-6.7) and 5.2 × 106 CD34+ cells/kg bw (range, 2.1-8.4) on the 1st, 2nd, 3rd and 4th apheresis session, respectively.
Predictive factors for a higher CD34+ cell collection at first apheresis were male sex (p = 0.003) as well as CD34+ cell count/µl in peripheral blood (p < 0.0001). White blood cell count, platelets, hemoglobin, and age had no significant predictive value. Predicted versus observed number of CD34+ cells/kg bw collected demonstrated a very strong linear correlation (r = 0.93, p < 0.0001).
Of the routinely monitored indicators in ASCC, male sex and CD34+ cell count in peripheral blood were predictive factors of the collection yield. The CD34+ cell count was used to prospectively calculate the minimal number of collected CD34+ cells in order to determine the necessary duration of the individual apheresis session.
Nothing to disclose.