Large‐volume‐apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients
María Juliana Majadoa b✉, Alfredo Minguelac d, Consuelo González‐Garcíab e, Eduardo Salidob e, Miguel Blanquerb e, Consuelo Funesb e, Carmen L. Insaustib e, Ana M. García-Hernándezb e, Jose Maria Moraledab e, Alfonso Javier Rodriguez-Moralesb e
- aServicio de Hematología, Hospital Virgen de la Arrixaca, Murcia, Spain. juliana.majado@carm.es
- bServicio de Hematología, Hospital Virgen de la Arrixaca, Murcia, Spain
- cServicio de Inmunología, Hospital Virgen de la Arrixaca, CIBERehd, Murcia, Spain
- dServicio de Inmunología, Hospital Virgen de la Arrixaca, CIBERehd, Murcia, Spain
- eServicio de Hematología, Hospital Virgen de la Arrixaca, Murcia, Spain
- ✉Corresponding author
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Abstract
Given that pre-apheresis CD34(+) cell count (PA-CD34) predicts the apheresis' yield, a minimum of 5 to 20 PA-CD34/microl is required in many institutions to initiate cell collection. The aim of this study was to clarify whether large-volume-apheresis (LVA) could facilitate progenitor cell transplantation in patients with low PA-CD34. Apheresis was initiated in 226 patients, disregarding PA-CD34, at days: +5 in G-CSF, +10 in cyclophosphamide+G-CSF, and +15 to +20 in other chemotherapy+G-CSF mobilization, when leucocytes >2.5 x 10(9)/L. Four times the blood volume was processed. Patients were grouped according to their PA-CD34: >or=10/microl (group-A, n = 143); <10/microl but >or=5/microl (group-B, n = 40) and <5/microl (group-C, n = 43). No differences were found in diagnoses, gender, age, previous treatments or mobilization regimen between groups. Enough CD34(+) cells (>1.9 x 10(6)/kg) were obtained in 31 patients (72%) from group-C, although in this group two mobilizations were needed in 20 patients (46.5%), compared to 5 (3.5%) and 1 (2.5%) in groups A and B, respectively (P < 0.01). Evenly three apheresis or more were required in 28 patients (65.1%) from group-C, compared to 8 (5.6%) and 6 (15.0%) in groups A and B, respectively (P < 0.01). In conclusion LVA can facilitate autologous transplantation in poor-mobilizer-patients, low PA-CD34 should not be an inflexible exclusion factor.