J Korean Med Sci.  2014 Jan;29(1):110-116. 10.3346/jkms.2014.29.1.110.

Optimal Time to Start Peripheral Blood Stem Cell Collection in Children with High-Risk Solid Tumors

• Sung KW
• Chueh HW
• Lee NH
• Kim DH
• Lee SH
• Yoo KH
• Koo HH
• Kang ES
• Kim DW

• KMID: 1796923
• DOI: http://doi.org/10.3346/jkms.2014.29.1.110

Abstract

In order to clarify the optimal timing for peripheral blood stem cell (PBSC) collection, PBSC collection records of 323 children who were scheduled to undergo autologous stem cell transplantation from two study periods differing in the timing of PBSC collection were analyzed. In the early study period (March 1998 to August 2007, n=198), PBSC collection was initiated when the peripheral WBC count exceeded 1,000/microL during recovery from chemotherapy. Findings in this study period indicated that initiation of PBSC collection at a higher WBC count might result in a greater CD34+ cell yield. Therefore, during the late study period (September 2007 to December 2012, n=125), PBSC collection was initiated when the WBC count exceeded 4,000/microL. Results in the late study period validated our conclusion from the early study period. Collection of a higher number of CD34+ cells was associated with a faster hematologic recovery after transplant in the late study period. Initiation of PBSC collection at WBC count > 4,000/microL was an independent factor for a greater CD34+ cell yield. In conclusion, PBSC collection at a higher WBC count is associated with a greater CD34+ cell yield, and consequently a faster hematologic recovery after transplant.

Keyword

High-Dose Chemotherapy; Autologous Stem Cell Transplantation; Peripheral Blood Stem Cell Collection

MeSH Terms

Adolescent
Adult
Antigens, CD34/metabolism
Antineoplastic Agents/therapeutic use
Child
Child, Preschool
Female
Granulocyte Colony-Stimulating Factor/therapeutic use
Hematopoietic Stem Cell Transplantation/*methods
Hematopoietic Stem Cells/*cytology
Humans
Infant
Leukocyte Count
Male
Neoplasms/*blood/drug therapy
Transplantation, Autologous
Young Adult
Antigens, CD34
Antineoplastic Agents
Granulocyte Colony-Stimulating Factor

Figure

• 

  Fig. 1 Results of PBSC collection in the early study period. (A) PB WBC counts increase as the number of leukapheresis days increased. (B) The number of CD34+ cells in PB is positively associated with the WBC count in PB with borderline significance. (C) Thus, daily CD34+ cell yields reflect the WBC counts before leukapheresis, with the highest yields obtained for WBC counts > 4,000/µL. (D) When assuming PBSC collection had been initiated at PB WBC counts exceeding 1,000/µL, 2,000/µL, and 4,000/µL in patients who underwent PBSC collection for 6-11 days, CD34+ cell yield for the first 3 days is highest for initiation at > 4,000/µL PB WBC. Median values are presented with bars.

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