Optimization of Timing to Start Apheresis and Blood Volume Processed by Preapheresis Counting of Peripheral Blood CD34+ Cells.

概要

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When collecting peripheral blood stem cells (PBSCs), it is important to reduce not only the number of apheresis, but also the volume of blood processed because the procedure is uncomfortable for pediatric patients. We monitored peripheral blood CD34+ cell count (pbCD34+) to optimize the collection method. Twenty-one mobilization courses were done with chemotherapy plus G-CSF (18 courses) and G-CSF alone (3) in 13 patients. Apheresis was started when pbCD34+ was above 10/μl, and the volume of blood processed was set based on the preapheresis pbCD34+ as 100-300 ml/kg. In 2 courses, apheresis was abandoned because of poor mobilization. The other 19 courses were grouped by pbCD34+ into 3 groups (Group A : pbCD34+ > 60/μl, B : 10-60, C : <10). In each group, the mean number of CD34+ cells collected (volume of blood processed) was as follows. A : 7.61 × 106/kg (148 ml/kg), B : 3.52 (340), C : 2.61 (517). As a result, 16 of 19 courses successfully collected more than 2.0 × 106 CD34+ cells/kg. Our method, with monitoring of pbCD34+ and setting of the volume of blood processed, proved useful for collecting PBSCs in pediatric patients.
特定非営利活動法人　日本小児血液・がん学会の論文