Allogeneic Hemapoietic Progenitor Cell Collection Using Four Different Cell Separators: A Retrospective Comparative Analysis.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5009-5009
Author(s):  
Mutlu Arat ◽  
Onder Arslan ◽  
Ender A. Soydan ◽  
Erol Ayyildiz ◽  
Klara Dalva ◽  
...  
Keyword(s):  
Stem Cell ◽  
Blood Volume ◽  
Current Practice ◽  
Collection Efficiency ◽  
Venous Access ◽  
Total Blood ◽  
Cd34 Cells ◽  
The Mean ◽  
Event Rates ◽  
Stem Cell Collection

Abstract The number of centers choosing peripheral blood stem cell (PBSC) source for allogeneic transplants is rapidly growing. To evaluate the current practice of PBSC collection and apheresis technology, we analyzed the efficiency of four different cell separators. Forty procedures, (10 for each separator) performed on various cell separators (Baxter-Amicus, Fenwal CS3000+, COBE-Spectra and Fresenius AS204), were analyzed retrospectively. All the donors were HLA identical siblings of the patients (M/F: 16/14) with a median age of 33 years (range, 16–62). There was no statistical difference between donor’s body weight (mean 35.7±15.8) and age between four groups. They received 5mcg/kg rhG-CSF (Amgen-Roche) sc. twice daily for 4 days and the stem cell collection was performed on the subsequent dose of G-CSF on day 5. Two to three times the total blood volume (total processed volume <13L) was processed for a target of 4x10e6/kg CD34+ cells. In all procedures peripheral veins were used for venous access and the mean procedure duration was 238±50 min. The soft ware versions installed for Amicus, CS3000+, Cobe and AS204 were 2.51, 3.81, 5.1 LRS, and 1.1.6.3 respectively. The volume of harvest material was significantly higher in AS-204 (p=0.0001) in comparison to remaining devices. The MNC and CD34 collection efficiency and adverse event rates were almost the same in all equipments. CD34+ cells of the harvest material and CD34+ gain per processed blood volume (CD34+x10e6/L) were not statistically different. Amicus showed significantly less platelet contamination in the harvest material (p=0.0001) in comparison to remaining apheresis devices. Post-procedural donor’s platelet loss was also significantly less with this device (p=0.0001). In conclusion all devices have a similar MNC and CD34+ cell collection efficiency and CD34+ cell gain per processed blood volume, but Amicus showed a clear benefit by lower drop rate of donor’s platelets, which led to lower contamination of the harvest material. Less contamination of the harvest material and donor’s minor platelet drop were advantages of Amicus device over CS3000+, Spectra and AS-204 concerning cell processing and donor safety, respectively. Comparison of Different Cell Separators Baxter Amicus Fenwall CS3000+ Cobe Spectra Fresenius AS204 P Pre WBC (x10e9/L) 53.8±15.0 49.7±12.8 50.4±14.5 57.0±15.5 0.67 Pre CD34+ (/mcl) 118.3±47.3 66.2±34.9 125.1±60.3 116.9±108.9 0.26 Total blood vol proc. L 10.9±1.4 10.7±2.5 10.5±1.6 11.3±1.6 0.82 Harvest Vol. (ml) 131.1±26.4 175.8±55.2 153.9±50.5 270.4±73.7* 0.0001 MNC Coll. Eff. (%) 41.6±25.5 62.7±22.1 59.7±40.9 62.5±51.5 0.53 CD34 Coll. Eff. (%) 37.2±18.5 85.6±54.5 87.14±72.8 81.9±56.9 0.99 Tot. CD34 (x10e6) 396.3±198.9 233.4±122.9 361.2±169.6 314.3±100.5 0.11 CD34x10e6 /Vol Processed (L) 37.2±18.5 23.9±15.5 35.4±18.1 28.1±9.5 0.11 Harvest Plt (x10e9/L) 850.4±247.6* 2949±1361.9 3217±1118.2 2211.4±1506.1 0.0001 Donor’s Plt drop (%) 15.9±5.8* 56.5±35.1 45.6±9.8 47.8±15.4 0.0001

Mobilization, Harvesting and Selection of Peripheral Blood Stem Cells in Patients with Autoimmune Diseases Undergoing Non-Myeloablative Autologous Hematopoietic Stem Cell Transplantation.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1980-1980
Author(s):  
Laisvyde Statkute ◽  
Larissa Verda ◽  
Yu Oyama ◽  
Marcelo Villa ◽  
Thomas Shook ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Autoimmune Diseases ◽  
Peripheral Blood ◽  
Hematopoietic Stem ◽  
Positive Correlation ◽  
Cd34 Cells ◽  
The Mean ◽  
Stem Cell Collection ◽  
Selection Of

Abstract We have analyzed peripheral blood stem cell (PBSC) mobilization, harvesting and selection properties in 128 patients with severe autoimmune diseases undergoing non-myeloablative autologous hematopoietic stem cell transplantation (HSCT) (50 patients with systemic lupus erythematosus (SLE), 43 - with multiple sclerosis (MS), 15 - with Crohn’s disease (CD), 8 - with scleroderma (Scl), and 12 - with others). Female/male ratio and mean age (range) were 90/38 patients, and 34 (14 to 59) years old, respectively. Mobilization regimen included cyclophosphamide 2g/m2 and G-CSF 10 mcg/kg (except for SLE patients 5 mcg/kg). Forty one patients underwent stem cell collection using Baxter CS300, 78 patients - Spectra, and for 9 patients both apheresis machines were utilized. The mean number of aphereses was 1.8 (range 1–10). Patients with SLE required the largest number of apheresis sessions (mean 2.4), comparing to patients with CD (mean 1.9), Scl (mean 1.4), MS (mean 1.3). Five patients additionally required bone marrow harvest for collection of adequate numbers of stem cells. One patient failed to reach CD34+ cell number of 1.0x106/kg, therefore did not proceed to HSCT. The mean number of CD34+ cells in each apheresis unit was 6.07+−6.96x106/kg (the highest of 9.22+−8.52x106/kg in patients with MS, and the lowest of 3.93+−4.48x106/kg in patients with SLE). Ninety eight patients underwent stem cell selection with CEPRATE SC (N=18), Isolex 300iv1.12 (N=2) or Isolex 300iv2.5 (N=78) stem cell concentrator. The mean purity of selected products was 74.3% (the highest of 81.1% attained in patients with Scl); mean recovery of CD34+cells was 61.2%. T cell reduction by average of 3.7 logs was achieved. The mean number of infused CD34+ cells was 7.24+−5.5x106/kg. The highest mean number of CD34+ cells/kg were infused to patients with MS (9.04+−6.74x106/kg), the lowest - to patients with SLE (5.78+−4.13x106/kg). We found a moderate positive correlation between peripheral blood (PB) CD34+ cells/ul and PB WBC/ul (R=0.34, p<0.05), PB platelets/ul (R=0.51, p<0.05) and a strong positive correlation between PB CD34+ cells/ul and the number of CD34+ cells/kg/apheresis (R=0.67, p<0.05). A weak positive correlation was observed between the number of infused CD34+cells/kg and faster WBC engraftment (ANC>500) and platelet engraftment (platelet count>20K). There was no toxicity observed in our patient population during peri-mobilization period except for 1 patient with SLE who died of disseminated mucormycosis 1 week after stem cell collection. Mobilization and selection of PBSC are safe and efficient in patients with severe autoimmune diseases undergoing non-myeloablative autologous HSCT.

High Correlation of Pre-Apheresis Peripheral Blood CD34+ Cell Counts with Final Apheresis Product CD34+ Cell Count by Using a More Accurate Determination of Patient Blood Volume

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2996-2996
Author(s):  
Brandon Parker ◽  
James Hastings ◽  
Jill Folkert ◽  
Gayla Nagy ◽  
Carlos Bachier ◽  
...  
Keyword(s):  
Stem Cell ◽  
Cell Count ◽  
Blood Volume ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Accurate Determination ◽  
Blood Stem Cell ◽  
Cell Counts ◽  
The Mean ◽  
Stem Cell Collection

Abstract Abstract 2996 The final apheresis product CD34+ cell count per Kg of recipient weight is used to determine if additional apheresis procedures are necessary to collect the targeted amount of hematopoietic stem cells for autologous peripheral blood stem cell transplantation. Flow cytometric analysis of CD34+ cells can take several hours. A more timely technique to predict apheresis product CD34+ cell counts during apheresis may help determine if further administration of cytokines is necessary or if apheresis catheters can be removed, and overall improve the efficiency of patient (pt) care. We performed a retrospective review of all pts undergoing autologous peripheral blood stem cell mobilization with granulocyte-colony stimulating factor (G-CSF) alone, G-CSF and plerixafor, or with chemotherapy followed by G-CSF, from July 2010 through May 2011 who underwent peripheral blood stem cell collection with apheresis on the COBE Spectra cell separator. Linear regression models were used to formulate the calculation of pt blood volume based on the pre-apheresis CD34+ cell count per micro liter of blood, the final apheresis product CD34+ cell counts, and the amount of blood processed during the apheresis procedure. This calculated blood volume is expressed by the formula BV = 82.5(patients weight in Kg) + 793. We then prospectively evaluated the next consecutive pts who underwent stem cell mobilization and apheresis in June and July 2011. Twenty-seven apheresis collections were done on 26 pts. Fourteen pts were female, and 12 pts were male. Seventeen pts were diagnosed with myeloma, 6 pts with NHL, and 3 pts with other diseases. Twenty pts were mobilized with G-CSF (10 ug/kg daily) with apheresis to begin on day 5. Fifteen of the 20 pts required plerixafor on day 4 because of low peripheral blood CD34+ cell counts (< 10/ul). Six pts were mobilized with chemotherapy followed by G-CSF 10 ug/kg daily until peripheral CD34 cell counts recovered greater than 10/ul and then apheresis was started. Each pt had their blood volume calculated according to the formula above and the peripheral blood CD 34+ cell count was measured on the first and second day of apheresis. The peripheral blood CD 34+ cell count/ul was multiplied by 1000 and this product was multiplied by the calculated blood volume and then divided by the pts weight [(PBCD34+ cell count × 1000) × BV]/Kg to determine the predicted apheresis product CD34+ cell count, which was then compared to the actual apheresis product final CD34+ cell count. On the first day of collection the mean for the predicted product CD34+ cell count was 4.98 × 106 +/− 3.1 × 106, and the actual apheresis product CD34+ cell count was 4.61 × 106 +/− 2.90 × 106 (Pearson correlation r value of 0.913 and a p value <0.001)(see figure). Nineteen collections were evaluable on the second day of collection with the mean for the predicted product CD34 + cell count of 2.08 × 106 +/− 1.64 × 106, and the mean for the actual apheresis product CD34+ cell count of 2.29 × 106 +/− 0.768 × 106 (Pearson correlation r value of 0.620 with a p value of 0.005). There was no significant difference in the correlation between patients mobilized with G-CSF alone, G-CSF and plerixafor or after chemotherapy and G-CSF. In conclusion, a more accurate determination of patient blood volume allowed for a high degree of correlation on the first day of peripheral blood stem cell collection on the COBE Spectra machine between the predicted product CD34+ cell count and the actual apheresis product CD34+ cell count. An accurate prediction of the final apheresis product CD34+ cell count may allow for less cytokine administration, quicker removal of apheresis catheters, and more efficient disposition of patients undergoing peripheral blood stem cell collection. Disclosures: Shaughnessy: Otsuka: Honoraria, Speakers Bureau; Millenium: Honoraria, Speakers Bureau; Genzyme: Consultancy, Honoraria, Research Funding, Speakers Bureau.

Efficacy and Risk Factors Analysis of Upfront Autologous Stem Cell Mobilization Using Plerixafor and Granulocyte-Colony Stimulating Factor (GCSF) in Patients with Multiple Myeloma

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3856-3856
Author(s):  
Adebayo Ogunniyi ◽  
Mabel Rodriguez ◽  
Sean M. Devlin ◽  
Nelly G. Adel ◽  
Heather Landau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Platelet Count ◽  
Retrospective Study ◽  
Collection Efficiency ◽  
Factors Associated ◽  
Cd34 Cells ◽  
Cell Mobilization ◽  
Number Of Cycles ◽  
Stem Cell Collection

Abstract Background: G-CSF with or without cyclophosphamide has been commonly used in multiple myeloma (MM) for stem cell (SC) collection prior to autologous stem cell transplantation (ASCT). Several risk factors including age, prolonged exposure to lenalidomide, and low platelet count are associated with suboptimal stem cell harvest. Plerixafor selectively and reversibly binds to the chemokine receptor CXCR4 and blocks its interaction with stromal cell-derived factor-1α. This drug was approved by the FDA for stem cell mobilization in MM, based on phase III studies demonstrating the superiority of plerixafor and G-CSF over G-CSF alone in achieving a predetermined target yield of 6 × 106CD34+ cells/kg collected in < 2 phereses; however, this outcome is not clinically relevant. The purpose of this retrospective study is to examine the SC mobilization efficiency associated with plerixafor using a more clinically relevant outcome, and to identify risk factors associated with poor SC mobilization, including the potential impact of prior exposure to lenalidomide-containing regimens. Patients and methods: This retrospective study examined MM patients mobilized with plerixafor and G-CSF upfront as part of initial therapy at Memorial Sloan Kettering Cancer Center between 4/1/2009 and 8/1/2013. Baseline characteristics examined included age, race, gender, platelet count, WBC count, and marrow plasmacytosis prior to mobilization. Treatment characteristics examined included type of induction regimen (distinguishing regimens containing lenalidomide only, bortezomib only, or both), number of cycles received, time between last chemotherapy and SC mobilization, time between start of treatment and SC collection, and prior radiation. The primary endpoint was the rate of SC collection success, defined as the ability to collect at least 5 x 106CD34+ cells/kg during the first set of phereses, which would be sufficient for two ASCT. The secondary endpoint was SC collection efficiency, measured by the number of CD34+ cells yielded per pheresis performed during the first set of stem cell collection. Linear regression was used to examine the univariate effect of baseline and treatment variables on SC collection efficiency. Variables significant at the 0.05 level were entered into a multivariable model. Results: A total of 138 MM patients were mobilized with plerixafor and G-CSF before proceeding to stem cell collection. The rate of SC collection success was 92.8%. Due to this high success rate, we could not identify independent risk factors associated with poor SC mobilization. When considering SC efficiency as outcome, the average efficiency for the entire cohort was 7.25 x 10^6 CD34+ cells/kg/pheresis. Increased age (p=0.005), shorter time between treatment start and SC collection (p=0.05), higher number of cycles received during induction treatment (p=0.042), lower platelet count (p=0.009) and lower WBC prior to G-CSF (p=0.01), and exposure to lenalidomide only (p=0.011) were all identified as risk factors by univariate analysis. Only lower WBC prior to GCSF (p=0.009) maintained statistical significance after multivariate analysis. Conclusions: This retrospective study shows that plerixafor is a highly effective agent for SC mobilization and collection in MM patients, with only few patients failing to achieve the target collection regardless of baseline or treatment characteristics including prior lenalidomide exposure. However, we identified WBC prior to G-CSF administration as a predictor of SC collection efficiency. These results provide strong support to the upfront use of plerixafor and G-CSF for SC mobilization in MM patients. A cost analysis is currently in progress comparing this SC collection modality with other conventional means currently being employed in patients with MM. Disclosures No relevant conflicts of interest to declare.

scholarly journals Impact of Induction Treatment on Stem Cell Collection: A COVID Related Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4848-4848
Author(s):  
Brad Rybinski ◽  
Ashraf Z. Badros ◽  
Aaron P. Rapoport ◽  
Mehmet Hakan Kocoglu
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Research Funding ◽  
Median Number ◽  
Cell Transplant ◽  
Cd34 Cells ◽  
Significant Difference ◽  
Number Of Cycles ◽  
Time Required ◽  
Stem Cell Collection

Abstract Introduction: Standard induction therapy for multiple myeloma consists of 3-6 cycles of bortezomib, lenalidomide, and dexamethasone (VRd) or carfilzomib, lenalidomide and dexamethasone (KRd). Receiving greater than 6 cycles of a lenalidomide containing regimen is thought to negatively impact the ability to collect sufficient CD34+ stem cells for autologous stem cell transplant (Kumar, Dispenzieri et al. 2007, Bhutani, Zonder et al. 2013). Due to the COVID-19 pandemic, at least 20 patients at University of Maryland Greenebaum Comprehensive Cancer Center (UMGCC) had transplant postponed, potentially resulting in prolonged exposure to lenalidomide containing induction regimens. Here, in the context of modern stem cell mobilization methods, we describe a retrospective study that suggests prolonged induction does not inhibit adequate stem cell collection for transplant. Methods: By chart review, we identified 56 patients with multiple myeloma who received induction with VRd or KRd and underwent apheresis or stem cell transplant at UMGCC between 10/1/19 and 10/1/20. Patients were excluded if they received more than 2 cycles of a different induction regimen, had a past medical history of an inborn hematological disorder, or participated in a clinical trial of novel stem cell mobilization therapy. We defined 1 cycle of VRd or KRd as 1 cycle of "lenalidomide containing regimen". In accordance with routine clinical practice, we defined standard induction as having received 3-6 cycles of lenalidomide containing regimen and prolonged induction as having received 7 or more cycles. Results: 29 patients received standard induction (Standard induction cohort) and 27 received prolonged induction (Prolonged induction cohort) with lenalidomide containing regimens. The median number of cycles received by the Standard cohort was 6 (range 4-6), and the median number of cycles received by the Prolonged cohort was 8 (range 7-13). The frequency of KRd use was similar between patients who received standard induction and prolonged induction (27.58% vs. 25.93%, respectively). Standard induction and Prolonged induction cohorts were similar with respect to clinical characteristics (Fig 1), as well as the mobilization regimen used for stem cell collection (p = 0.6829). 55/56 patients collected sufficient stem cells for 1 transplant (≥ 4 x 10 6 CD34 cells/kg), and 40/56 patients collected sufficient cells for 2 transplants (≥ 8 x 10 6 CD34 cells/kg). There was no significant difference in the total CD34+ stem cells collected at completion of apheresis between standard and prolonged induction (10.41 and 10.45 x 10 6 CD34 cells/kg, respectively, p = 0.968, Fig 2). Furthermore, there was no significant correlation between the number of cycles of lenalidomide containing regimen a patient received and total CD34+ cells collected (R 2 = 0.0073, p = 0.5324). Although prolonged induction did not affect final stem yield, prolonged induction could increase the apheresis time required for adequate collection or result in more frequent need for plerixafor rescue. There was no significant difference in the total number of stem cells collected after day 1 of apheresis between patients who received standard or prolonged induction (8.72 vs. 7.96 x 10 6 cells/kg, respectively, p = 0.557). However, patients who received prolonged induction were more likely to require 2 days of apheresis (44% vs. 25%, p = 0.1625) and there was a trend toward significance in which patients who received prolonged induction underwent apheresis longer than patients who received standard induction (468 vs 382 minutes, respectively, p = 0.0928, Fig 3). In addition, longer apheresis time was associated with more cycles of lenalidomide containing regimen, which neared statistical significance (R 2 = 0.0624, p = 0.0658, Fig 4). There was no significant difference between standard and prolonged induction with respect to the frequency of plerixafor rescue. Conclusions: Prolonged induction with lenalidomide containing regimens does not impair adequate stem cell collection for autologous transplant. Prolonged induction may increase the apheresis time required to collect sufficient stem cells for transplant, but ultimately clinicians should be re-assured that extending induction when necessary is not likely to increase the risk of collection failure. Figure 1 Figure 1. Disclosures Badros: Janssen: Research Funding; J&J: Research Funding; BMS: Research Funding; GlaxoSmithKline: Research Funding.

Optimizing donor selection in order to establish a cord blood banking facility: maternal and obstetric factors impact

Open Medicine ◽  
2007 ◽  
Vol 2 (2) ◽  
pp. 180-189 ◽  
Author(s):  
Mihaela Chivu ◽  
Serban Nastasia ◽  
Camelia Sultana ◽  
Coralia Bleotu ◽  
Irina Alexiu ◽  
...  
Keyword(s):  
Cord Blood ◽  
Blood Volume ◽  
Donor Selection ◽  
Gestation Length ◽  
Gestational Length ◽  
Cell Content ◽  
Cd34 Cells ◽  
Newborn Weight ◽  
The Mean ◽  
Obstetric Factors

AbstractIn this study, we analyzed the obstetric factors affecting total nucleated cells (TNC) content of cord blood units to establish the criteria for umbilical cord blood (UCB) donor selection in our geographic area.UCB was collected from normal uncomplicated pregnancies. In every case, following data were recorded: (1) gestation length; (2) type of delivery (cesarean or vaginal); and (3) newborn characteristics: weight and sex. For each sample, TNC content, percentage and number of CD34+ cells, and viability were analyzed.The results showed that TNC content increases with cord blood volume, gestational length and newborn weight. The mean blood volume and the mean TNC per unit were 42.37 ± 13.5 ml and 55.49 ± 19.4 × 107, respectively. Stepwise regression analysis revealed a positive and significant correlation (r= 0.89) between these two variables. Meanwhile the CD34+ cell content remains unchanged in deliveries at 32–40 weeks of gestation. The mean CD34+ percentage obtained was 0.37 ± 0.06, and the total number of CD34+ cells was 4.827 ± 0.8204 × 104 / mL UCB.Concluding, the maternal and obstetric factors have a significant impact on UCB cell quantity and quality. The main criteria for UCB collection and storage resulted to be: a gestational age higher than 36–40 weeks and newborn weight > 3200g; gestation number ≤ 2 and placental weight > 700g can be added to the standard criteria to improve the bank efficiency. Our results have also become helpful in evaluating stored UCB units to establish the adequacy for clinical transplant utilization.

Circulation of sympathectomized dogs under pentobarbital anesthesia

1965 ◽  
Vol 208 (4) ◽  
pp. 790-794
Author(s):  
Shu Chien ◽  
Shunichi Usami
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Blood Volume ◽  
Total Blood Volume ◽  
Central Blood Volume ◽  
Total Blood ◽  
Pentobarbital Anesthesia ◽  
Blood Flows ◽  
The Mean ◽  
Mean Circulation

In sympathectomized-splenectomized dogs under pentobarbital anesthesia, the total blood volume averaged 78 ml/kg, with 20% in the splanchnic circulation and 28% in the central blood volume. These values are almost the same as those found in the splenectomized (control) dogs with the sympathetic system intact. The over-all and the splanchnic Fcells factors are also not significantly different between these two groups. The sympathectomized animals had lower arterial pressure, cardiac output, and splanchnic blood flow, but the resistances calculated for the total and the splanchnic circulations were not significantly different from those of the control dogs. The mean circulation times for the total, the central, and the splanchnic circulations were all longer in the sympathectomized dogs. The data indicate that, under pentobarbital anesthesia, sympathectomized dogs are characterized by slower blood flows without any significant changes in either the blood volume or vascular resistance.

Effect of the Adminstration of Rituximab between Mobilization Chemotherapy and Leukapheresis on Stem Cell Collection Parameters: A Study of Fifty NHL Patients Mobilized Using Intermediate Dose Cyclophosphamide and Sequential GM-CSF and G-CSF.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2874-2874
Author(s):  
Asad Bashey ◽  
Lin Liu ◽  
Anita Ihasz ◽  
Ewa Carrier ◽  
Januario Castro ◽  
...  
Keyword(s):  
Stem Cell ◽  
B Cell ◽  
Time Course ◽  
Cumulative Probability ◽  
Gm Csf ◽  
Cd34 Cells ◽  
Group 2 ◽  
Stem Cell Collection ◽  
Intermediate Dose ◽  
Group 1

Abstract We have previously reported that intermediate dose cyclophosphamide followed by sequential GM-CSF and G-CSF (iCy/GM/G) provides efficient mobilization for patients undergoing autografting. Furthermore, the predictable time course of mobilization with this regimen obviates the need for weekend leukaphereses (Blood 2003: 957a). Recently, the addition of rituximab to mobilization regimens for B-cell NHL has been shown to be effective at depleting contaminating B-cells from the leukapheresis product. However, the effect of rituximab administered for in-vivo purging, on mobilization and stem cell collection parameters is unclear. We compared leukapheresis (LP) yield parameters, and the time course of stem cell mobilization in 23 consecutive B-cell NHL patients mobilized with iCy/GM/G plus rituximab (group 1) with 27 consecutive B-cell NHL patients mobilized with the same regimen without rituximab (group 2). The iCy/GM/G regimen consisted of cyclophosphamide 1.5g/m2 (d1), GM-CSF 500 mcg/d (d 3–7), G-CSF (d 8 until completion of LP) 600mcg/d for weight ≤80kg, 960 mcg for weight &gt; 80 kg. Rituxan was administered at 375mg/m2 as a single dose on d8. LP was begun on d 11 irrespective of WBC. D1 was usually a Friday in order to avoid weekend LP. Patients underwent up to 20 liter LP for ≤ 5 days (median =3, range 1–5 for both groups) with a target collection of &gt; 5 x 10e6 CD34+ cells/kg. The groups were well matched for median age, gender, number of prior chemotherapy regimens (median=2 for both groups), prior pelvic XRT and histological subtype of B-NHL (p=NS in all cases). The estimated (Kaplan-Meier) cumulative probability of achieving a target collection of 2 x 10e6 CD34+ cells/kg on d 1–5 was 0.43, 0.70, 0.78, 0.84, 0.84 respectively for group 1 and 0.22, 0.69, 0.77, 0.84, 0.84 respectively for group 2. The corresponding probabilites of achieving 5 x 10e6 CD34+ cells/kg on d 1–5 were 0.22, 0.39, 0.57, 0.57, 0.57 (group 1) and 0.11, 0.30, 0.46, 0.59, 0.59 (group 2) (p=NS Log-rank test). Percentage of CD34+ cells in the LP product (LP CD34%) was measured daily. Maximums LP CD34% was seen on LP d1 for both groups with a fall on subsequent days (p=NS between groups 1 and 2). Toxicities experienced were generally mild consisting mostly of bone pain and fevers and were similar in both gropups. No patient required admission for febrile neutropenia. The number of CD34+ cells infused were similar for both groups (median 5.9 vs.5.7 x10e6 CD 34+ cells/kg). Median time to reach ANC &gt; 500/mm3 and platelets &gt; 20,000/mm3 were identical between groups 1 and 2 (d11 and d 10 respectively). These data show that the addition of rituximab administered on d 8 to the iCy/GM/G regimen in patients with B-NHL does not impair the yield of CD34+ cells, or the tolerability of the regimen. Furthermore, the time course of the mobilization and therefore the predictbility of the collection is not compromised. Maximum cumulative yield of CD34+ cells is achieved within 4 days of LP with no patient benefitting from a fifth day of collection. The additional cost and inconvenience of weekend leukapheresis can be avoided in all cases using this regimen.

The Role of SDF-1/CXCR4 in the Procession of Auto-Stem Cell Transplantation of Multiply Myeloma Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5150-5150
Author(s):  
Caixia Li ◽  
De Pei Wu ◽  
Xue Guang Zhang
Keyword(s):  
Stem Cell ◽  
Plasma Levels ◽  
Peripheral Blood Stem Cell ◽  
Cxcr4 Expression ◽  
Lower Plasma ◽  
Cxcr4 Receptor ◽  
Cd34 Cells ◽  
The Mean ◽  
Poor Mobilizers

Abstract CXCR4, receptor of the chemokine stromal derived factor-1 (SDF-1), is expressed on CD34+ cells, and has been implicated in the process of CD34+ cell migration and homing. We studied the mobilization of CD34/CXCR4 cells and the plasma levels of SDF-1 and sgp130 in 22 patients, 11 acute Leukemia, 5 non-Hodgkin’s lymphoma, and 6 multiply myloma respectably, receiving cyclophosphamide (Cy) and plus G-CSF, or Mitoxantrone(Mit) and Cytarabine plus G-CSF for peripheral blood stem cell (PBSC) mobilization and autotransplantation. We observed lower plasma levels of SDF-1 in PBSCs compared with premobilized PB and bone marrow samples. The average levels of SDF-1 and sgp130 were 24.67±5.58ng/ml and 106.2±16.4ng/ml respectively while the level of SDF-1 as well as sgp130 decreased to 14659±2.11ng/ml(p&lt;0.05)and 58.8±29.1ng/ml(p&lt;0.05) respectively on day when PBSC was collected after mobilization. SDF-1 levels in the apheresis collections of the “good mobilizers” (patients who collected a minimum of 2 × 106 CD34+ cells/kg in one to three PBSC collections) were significantly lower than the apheresis collections of the “poor mobilizers” (&lt;2 × 106 CD34+ cells/kg in the three cycles of PBSC collections; 14.82 ± 7.08 ng/ml versus 27.2 ± 8.13 ng/ml; p&lt;0.01). The mean percentage of CD34+ cells expressing CXCR4 in the apheresis collections was decreased in the PBSC collections compared with premobilization values ranging from 32.09±5.39% to 22.4±5.92%. But the mean CXCR4 expression on CD34+ cells of the good mobilizers was not different from the expression on CD34+ cells of poor mobilizers. Furthermore, the levels of sgp130 closely correlated with SDF-1 levels (r = 0.87; p &lt; 0.001); the plasma level of SDF-1 and expression of CXCR4 on the CD34+ cells were gradually decreased in the PB of patients during the procession of mobilization; low plasma levels of SDF-1 turned out with good mobilization outcome, and the levels of SDF-1 correlated with sgp130, suggesting an association of these cytokines in mobilization of CD34+ cells.

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