Factors to Predict Autologous CD34 Positive Cells Harvest in the Patients with Malignant Lymphoproliferative Disorder

Sang Min Lee; Min-Jeong Kwon; Myung Joo Kang; Eun Joo Lee; Won Sik Lee; Chang Hak Sohn; Ja Young Lee; Jeong Nyeo Lee; Hawk Kim; Young Don Joo

doi:10.5045/kjh.2009.44.1.47

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Lee, Kwon, Kang, Lee, Lee, Sohn, Lee, Lee, Kim, and Joo: Factors to Predict Autologous CD34 Positive Cells Harvest in the Patients with Malignant Lymphoproliferative Disorder

Original Article

Korean J Hematol 2009;44(1):47-52.

Published online: 20 March 2009

DOI: https://doi.org/10.5045/kjh.2009.44.1.47

Factors to Predict Autologous CD34 Positive Cells Harvest in the Patients with Malignant Lymphoproliferative Disorder

Sang Min Lee, M.D.¹, Min-Jeong Kwon, M.D.¹, Myung Joo Kang, M.D.¹, Eun Joo Lee, M.D.¹, Won Sik Lee, M.D.¹, Chang Hak Sohn, M.D.¹, Ja Young Lee, M.D.², Jeong Nyeo Lee, M.D.², Hawk Kim, M.D.³, Young Don Joo, M.D.^1,

¹Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

²Department of Labatory Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

³Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

Correspondence to：Young Don Joo, M.D. Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine Gaegum-dong, Busangin-gu, Busan 614-735, Korea Tel: ＋82-51-890-6270, Fax: ＋82-51-895-6977 E-mail: yjoo@inje.ac.kr

Received 4 December 2008 Revised 22 January 2009 Accepted 30 January 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Autologous peripheral blood stem cell transplantation (PBSCT) has been used as a major treatment strateg for malignant lymphoproliferative disorder. The number of CD34 positive cells in the harvested product is a very important factor for achieving successful transplantation. We studied the factors that can predict the number of CD34 positive cells in the harvested product of multiple myeloma (MM) and Non-Hodgkin's lymphoma (NHL) patients after mobilizing them with chemotherapy plus G-CSF.

Methods

A total of 69 patients (MM 25 patients, NHL 44 patients) with malignant lymphoproliferative disorder had been mobilizedwith chemotherapy and granulocyte colony-stimulating growth factor from January, 2003 to July, 2008. We analyzed the clinical characteristics, the peripheral blood (PB) parameters and the number of CD34 positve cells in the PB and their correlation with the yield of PBPCs collected from the mobilized patients.

Results

The total number of leukapheresis sessions was 134 (mean: 1.94 session per patient), and the mean number of harvested CD34 positive cell per patient was 12.47×10⁶/kg. The number of harvested CD34 positive cells was correlated with the patient's height, the number of peripheral blood hematopoietic progenitor cells (HPC) and the number of PB CD34 positive cells at the harvest (P＜0.05). But the number of PB CD34 positive cell was the only significant factor for the quantity of harvested CD34 positive cells on the linear regression analysis (P＜0.05). More than 23.7/μL PB CD34 positive cells were needed to harvest 3×10⁶/kg CD34 positive cells, according to the ROC curve (P＜0.05).

Conclusion

The number of PB CD34 positive cells (≥23.7/μL) at the harvest might be the predictor of harvesting more than 3×10⁶/kg CD34 positive cell for autologous PBSCT in patients with malignant lymphoproliferative disorder.

Keywords: CD34 positive cell, Mobilization, Harvest

References

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Table 1.

The characteristics of a ll patients (n=69)

Agz (yrs, mean)	50.44 (15∼70)
Gender
Male	36
Femal	e33
M：F ratio	1：0.91
Body weight (kg) (mean)	61.14 (44∼88)
Height (cm) (mean)	163.13 (143∼186)
Disease (%)
Non-Hodgkin's lymphoma	44 (63.8)
Multiple myeloma	25 (36.2)
Chemotherapies before mobilization (mean)
Non-Hodgkin's lymphoma	6.39 (1∼11)
Multiple myeloma	4.62 (1∼12)
Interval from diagnosis
to mobilization (days, mean)	349.7 (38∼1834)

Table 2.

The findings of G-CSF^† between mobilization regimens for CD34+cell harvest

	ESHAP^‡	Cyclophosphamide	Others
Patients (%)	31(44.9)	32(46.8)	6(8.5)
Duration of G-CSF (days, mean)	8.41	11.27	9.0
Route of G-CSF
IV	23	26	6
SC	8	6	0
Dosage of G-CSF
10 ug/kg per 24 hours (qd)	31	16	3
5 ug/kg per 12 hours (bid)	0	16	3
Harvested CD34+ cells (×106/kg, mean)	10.6	14.92	9.0

^† : G-CSF, granulocyte-colony stimulating factor;

^‡ : ESHAP, etoposide, methylprednisolone, cytarabine, cisplatin

Table 3.

Peripheral blood findings at the time of CD34+ cell harvest (n=69)

Blood cells	Mean (range)
WBC (×10³/μL)	14.78 (1.32∼75.59)
Neutrophil	10.32 (0.56∼61.23)
Lymphocyte	0.87 (0.06∼4.5)
Monocyte	1.14 (0∼4.96)
HPC^† (/μL)	60.85 (4∼304)
CD34+ cell (/μL)	99.76 (61∼763.5)

^† : HPC, hematopoietic progenitor cell

Table 4.

The results of CD34+cell harvest (n=69)

Leukapheresis	Patients (%)^†	Mean CD34+cells (×106/kg, range)
1st	69 (100)	7.54 (0∼27)
2nd	46 (66.67)	6.39 (0.2∼34.8)
3rd	14 (20.29)	2.87 (0.2∼14.8)
4th	3 (4.34)	0.66 (0.3∼0.9)
5th	2 (2.9)	1 (0.3∼1.7)

^† : Total harvest=134, mean harvest per patient=1.94

Table 5.

The efficacy of CD34+cell harvest (n=61)

	Correlation coefficient for CD34+cell harvest
	Pearson correlation coefficient		P-value
Height	–0.297		0.014
HPC	0.419		0.010
PB^† CD34+cell	0.266		0.038
Linear regression for CD34+harvest (R2=0.485)
	Estimated coefficient (B)	Standard error	P-value
Height	–0.197	0.129	0.141
HPC	–0.010	0.026	0.698
PB CD34+cell	0.058	0.020	0.008

^† : PB, peripheral blood

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