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Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors

INTRODUCTION: Collection of peripheral blood stem cells (PBSCs) from healthy donors is a well-established process. We aimed to identify factors predictive of successful CD34+ PBSC collection and established a formula capable of predicting CD34+ cell yield. METHODS: We retrospectively evaluated 588 h...

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Autores principales: Kayser, Sabine, Schlenk, Richard F., Steiner, Marcus, Klüter, Harald, Wuchter, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601602/
https://www.ncbi.nlm.nih.gov/pubmed/37899994
http://dx.doi.org/10.1159/000531236
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author Kayser, Sabine
Schlenk, Richard F.
Steiner, Marcus
Klüter, Harald
Wuchter, Patrick
author_facet Kayser, Sabine
Schlenk, Richard F.
Steiner, Marcus
Klüter, Harald
Wuchter, Patrick
author_sort Kayser, Sabine
collection PubMed
description INTRODUCTION: Collection of peripheral blood stem cells (PBSCs) from healthy donors is a well-established process. We aimed to identify factors predictive of successful CD34+ PBSC collection and established a formula capable of predicting CD34+ cell yield. METHODS: We retrospectively evaluated 588 healthy adult donors (median age 29 years, range 18–69 years) at our institution from 2017 to 2022. The predicted minimal number of CD34+ cells was calculated as follows: (peripheral CD34+ cells/µL × adjusted collection efficiency of 30%) × total liters processed. This formula was further modified according to donor and recipient body weight (BW). RESULTS: Median total collection was 8.0 × 10(6) CD34+ cells/kg BW (range 1.0–47.1 × 10(6) cells/kg BW) with 522 donors (89%) collecting ≥5.0 × 10(6) cells/kg of recipient BW. A second leukapheresis (LP) was performed in 49 donors. Need for two LPs was more common in female donors (OR 6.68, 95% CI, 2.62–17.05; p < 0.001), donors with higher age (OR for 10 years difference 1.53, 95% CI, 1.15–2.03, p = 0.003), donors with WBC count <30 × 10(9)/L after 5 days of granulocyte-colony stimulating factor (G-CSF) stimulation (OR, 4.33; 95% CI, 1.59–11.83; p = 0.004), and a donor/recipient weight ratio <1 (OR 6.21, 95% CI, 2.69–14.34; p < 0.001). Predictive factors for optimal LP (i.e., ≥5.0 × 10(6) CD34+ cells/kg of recipient BW) were peripheral blood (PB) CD34+ cell count >50/µL (OR 12.82, range 6.34–25.92, p < 0.001), male donor (OR 2.77, range 1.06–7.23, p = 0.04), and a donor/recipient weight ratio >1 (OR 3.12, range 1.57–6.24, p = 0.001). WBC, 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 = 0.925, 95% CI, 0.912–0.936, p < 0.0001). CONCLUSIONS: Of the routinely monitored indicators in PBSC donors, CD34+ cell count in PB is the most important factor in predicting G-CSF-induced PBSC yields. Higher age, female sex, WBC <30 × 10(9)/L, and a donor/recipient weight ratio <1 are useful indicators for identifying suboptimal mobilizers. The modified formula has shown successful and consistent performance in the prediction of key outcome measures including the minimum CD34+ cell collection, determination of the required length of apheresis, and whether a second day of PBSC collection was necessary to achieve the respective collection goal.
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spelling pubmed-106016022023-10-27 Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors Kayser, Sabine Schlenk, Richard F. Steiner, Marcus Klüter, Harald Wuchter, Patrick Transfus Med Hemother Research Article INTRODUCTION: Collection of peripheral blood stem cells (PBSCs) from healthy donors is a well-established process. We aimed to identify factors predictive of successful CD34+ PBSC collection and established a formula capable of predicting CD34+ cell yield. METHODS: We retrospectively evaluated 588 healthy adult donors (median age 29 years, range 18–69 years) at our institution from 2017 to 2022. The predicted minimal number of CD34+ cells was calculated as follows: (peripheral CD34+ cells/µL × adjusted collection efficiency of 30%) × total liters processed. This formula was further modified according to donor and recipient body weight (BW). RESULTS: Median total collection was 8.0 × 10(6) CD34+ cells/kg BW (range 1.0–47.1 × 10(6) cells/kg BW) with 522 donors (89%) collecting ≥5.0 × 10(6) cells/kg of recipient BW. A second leukapheresis (LP) was performed in 49 donors. Need for two LPs was more common in female donors (OR 6.68, 95% CI, 2.62–17.05; p < 0.001), donors with higher age (OR for 10 years difference 1.53, 95% CI, 1.15–2.03, p = 0.003), donors with WBC count <30 × 10(9)/L after 5 days of granulocyte-colony stimulating factor (G-CSF) stimulation (OR, 4.33; 95% CI, 1.59–11.83; p = 0.004), and a donor/recipient weight ratio <1 (OR 6.21, 95% CI, 2.69–14.34; p < 0.001). Predictive factors for optimal LP (i.e., ≥5.0 × 10(6) CD34+ cells/kg of recipient BW) were peripheral blood (PB) CD34+ cell count >50/µL (OR 12.82, range 6.34–25.92, p < 0.001), male donor (OR 2.77, range 1.06–7.23, p = 0.04), and a donor/recipient weight ratio >1 (OR 3.12, range 1.57–6.24, p = 0.001). WBC, 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 = 0.925, 95% CI, 0.912–0.936, p < 0.0001). CONCLUSIONS: Of the routinely monitored indicators in PBSC donors, CD34+ cell count in PB is the most important factor in predicting G-CSF-induced PBSC yields. Higher age, female sex, WBC <30 × 10(9)/L, and a donor/recipient weight ratio <1 are useful indicators for identifying suboptimal mobilizers. The modified formula has shown successful and consistent performance in the prediction of key outcome measures including the minimum CD34+ cell collection, determination of the required length of apheresis, and whether a second day of PBSC collection was necessary to achieve the respective collection goal. S. Karger AG 2023-06-30 /pmc/articles/PMC10601602/ /pubmed/37899994 http://dx.doi.org/10.1159/000531236 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Research Article
Kayser, Sabine
Schlenk, Richard F.
Steiner, Marcus
Klüter, Harald
Wuchter, Patrick
Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors
title Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors
title_full Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors
title_fullStr Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors
title_full_unstemmed Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors
title_short Predicting Successful Hematopoietic Stem Cell Collection in Healthy Allogeneic Donors
title_sort predicting successful hematopoietic stem cell collection in healthy allogeneic donors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601602/
https://www.ncbi.nlm.nih.gov/pubmed/37899994
http://dx.doi.org/10.1159/000531236
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