Predicting PBSC harvest failure using circulating CD34 levels: Developing target-based cutoff points for early intervention

S. Sinha, D. Gastineau, Ivana Micallef, William Hogan, Stephen Maxted Ansell, F. Buadi, David M Dingli, Angela Dispenzieri, Morie Gertz, C. Greiner, S. Hayman, D. Inwards, Patrick Bruce Johnston, Martha Lacy, Mark R Litzow, L. Porrata, J. L. Winters, Shaji K Kumar

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

PBSCs are usually mobilized using G-CSF with or without chemotherapy. With the emergence of newer mobilizing agents, predicting poor mobilization may allow early intervention and prevent the costs and complications associated with remobilization. We retrospectively evaluated a cohort of 1556 patients seen between January 2000 and September 2008 with multiple myeloma (565; 36%), non-Hodgkin's lymphoma (NHL) (562; 36%), amyloidosis (345; 22%) or Hodgkin's disease (94; 6%), who were initially mobilized with single agent G-CSF. Sensitivity and specificity analysis was used to identify ideal peripheral blood CD34 count (PB-CD34) cutoff points that predicted successful collection. In patients with plasma cell disorders, a PB-CD34 count of 11, 17, 21 and 28/L by day 4 or 5 was required to collect a target of 2, 4, 8 or 12 million cells/kg, respectively. A CD34 yield of < 0.8 million cells/kg on first apheresis also predicted for <2 million CD34 cells/kg. For patients with NHL or Hodgkin's disease, a PB-CD34 count of <6 and <15/μL on day 4 or 5 predicted failure to achieve a target collection of 2 and 4 million cells/kg, respectively. This study suggests that PB-CD34 thresholds should be based on collection target to allow for early intervention and to prevent collection failures.

Original languageEnglish (US)
Pages (from-to)943-949
Number of pages7
JournalBone Marrow Transplantation
Volume46
Issue number7
DOIs
StatePublished - Jul 2011

Fingerprint

Granulocyte Colony-Stimulating Factor
Hodgkin Disease
Non-Hodgkin's Lymphoma
Blood Component Removal
Amyloidosis
Plasma Cells
Multiple Myeloma
Costs and Cost Analysis
Drug Therapy
Sensitivity and Specificity

Keywords

  • auto-SCT
  • lymphoma
  • multiple myeloma
  • peripheral CD34 count
  • plerixafor
  • stem cell mobilization

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Predicting PBSC harvest failure using circulating CD34 levels: Developing target-based cutoff points for early intervention",
abstract = "PBSCs are usually mobilized using G-CSF with or without chemotherapy. With the emergence of newer mobilizing agents, predicting poor mobilization may allow early intervention and prevent the costs and complications associated with remobilization. We retrospectively evaluated a cohort of 1556 patients seen between January 2000 and September 2008 with multiple myeloma (565; 36{\%}), non-Hodgkin's lymphoma (NHL) (562; 36{\%}), amyloidosis (345; 22{\%}) or Hodgkin's disease (94; 6{\%}), who were initially mobilized with single agent G-CSF. Sensitivity and specificity analysis was used to identify ideal peripheral blood CD34 count (PB-CD34) cutoff points that predicted successful collection. In patients with plasma cell disorders, a PB-CD34 count of 11, 17, 21 and 28/L by day 4 or 5 was required to collect a target of 2, 4, 8 or 12 million cells/kg, respectively. A CD34 yield of < 0.8 million cells/kg on first apheresis also predicted for <2 million CD34 cells/kg. For patients with NHL or Hodgkin's disease, a PB-CD34 count of <6 and <15/μL on day 4 or 5 predicted failure to achieve a target collection of 2 and 4 million cells/kg, respectively. This study suggests that PB-CD34 thresholds should be based on collection target to allow for early intervention and to prevent collection failures.",
keywords = "auto-SCT, lymphoma, multiple myeloma, peripheral CD34 count, plerixafor, stem cell mobilization",
author = "S. Sinha and D. Gastineau and Ivana Micallef and William Hogan and Ansell, {Stephen Maxted} and F. Buadi and Dingli, {David M} and Angela Dispenzieri and Morie Gertz and C. Greiner and S. Hayman and D. Inwards and Johnston, {Patrick Bruce} and Martha Lacy and Litzow, {Mark R} and L. Porrata and Winters, {J. L.} and Kumar, {Shaji K}",
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AU - Sinha, S.

AU - Gastineau, D.

AU - Micallef, Ivana

AU - Hogan, William

AU - Ansell, Stephen Maxted

AU - Buadi, F.

AU - Dingli, David M

AU - Dispenzieri, Angela

AU - Gertz, Morie

AU - Greiner, C.

AU - Hayman, S.

AU - Inwards, D.

AU - Johnston, Patrick Bruce

AU - Lacy, Martha

AU - Litzow, Mark R

AU - Porrata, L.

AU - Winters, J. L.

AU - Kumar, Shaji K

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N2 - PBSCs are usually mobilized using G-CSF with or without chemotherapy. With the emergence of newer mobilizing agents, predicting poor mobilization may allow early intervention and prevent the costs and complications associated with remobilization. We retrospectively evaluated a cohort of 1556 patients seen between January 2000 and September 2008 with multiple myeloma (565; 36%), non-Hodgkin's lymphoma (NHL) (562; 36%), amyloidosis (345; 22%) or Hodgkin's disease (94; 6%), who were initially mobilized with single agent G-CSF. Sensitivity and specificity analysis was used to identify ideal peripheral blood CD34 count (PB-CD34) cutoff points that predicted successful collection. In patients with plasma cell disorders, a PB-CD34 count of 11, 17, 21 and 28/L by day 4 or 5 was required to collect a target of 2, 4, 8 or 12 million cells/kg, respectively. A CD34 yield of < 0.8 million cells/kg on first apheresis also predicted for <2 million CD34 cells/kg. For patients with NHL or Hodgkin's disease, a PB-CD34 count of <6 and <15/μL on day 4 or 5 predicted failure to achieve a target collection of 2 and 4 million cells/kg, respectively. This study suggests that PB-CD34 thresholds should be based on collection target to allow for early intervention and to prevent collection failures.

AB - PBSCs are usually mobilized using G-CSF with or without chemotherapy. With the emergence of newer mobilizing agents, predicting poor mobilization may allow early intervention and prevent the costs and complications associated with remobilization. We retrospectively evaluated a cohort of 1556 patients seen between January 2000 and September 2008 with multiple myeloma (565; 36%), non-Hodgkin's lymphoma (NHL) (562; 36%), amyloidosis (345; 22%) or Hodgkin's disease (94; 6%), who were initially mobilized with single agent G-CSF. Sensitivity and specificity analysis was used to identify ideal peripheral blood CD34 count (PB-CD34) cutoff points that predicted successful collection. In patients with plasma cell disorders, a PB-CD34 count of 11, 17, 21 and 28/L by day 4 or 5 was required to collect a target of 2, 4, 8 or 12 million cells/kg, respectively. A CD34 yield of < 0.8 million cells/kg on first apheresis also predicted for <2 million CD34 cells/kg. For patients with NHL or Hodgkin's disease, a PB-CD34 count of <6 and <15/μL on day 4 or 5 predicted failure to achieve a target collection of 2 and 4 million cells/kg, respectively. This study suggests that PB-CD34 thresholds should be based on collection target to allow for early intervention and to prevent collection failures.

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KW - plerixafor

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