Factors influencing the collection of peripheral blood stem cells in patients with acute myeloblastic leukemia and non-myeloid malignancies

Factors influencing the collection of autologous peripheral blood stem cells (PBSCs) were studied in 182 mobilization procedures performed on 145 consecutive patients with acute myeloblastic leukemia (AML; n = 67) and with various non-myeloid malignancies (NMM; n = 78). PBSC were collected following mobilization with chemotherapy, treatment with granulocyte colony-stimulating factor (G-CSF) or chemotherapy plus G-CSF. Fewer colony-forming unit granulocyte-macrophages (CFU-GMs) were collected from patients with AML than from patients with NMM (P < 0.0001), although there were no differences in the numbers of CD34(+) cells collected between both groups. Multiple regression analysis showed that chemotherapy alone was predictive of a low CD34(+) yield in patients with NMM (regression coefficient (RC) = -2.1; P = 0.003). In addition, the interactions "diagnosis mutliple myeloma (MM) x mobilization with chemotherapy" (RC = 2.9; P = 0.004) and "diagnosis MM x mobilization with chemotherapy plus G-CSF" (RC = 2.1; P = 0.04) also remained in the model, both showing a favorable influence. In AML, mobilization with chemotherapy plus G-CSF was associated with higher CD34(+) yields (P = 0.003). In this subgroup of patients, multiple regression analysis identified the number of cycles of previous chemotherapy (<= 2 cycles; RC = 1.3; P = 0.03) and peripheral blood counts (WBC >= 1.5 x 10(9)/l and monocytes >20%; RC = 0.8; P = 0.02) as the factors most predictive of CD34(+) cell yield. These findings emphasize the need to optimize harvesting technique to enhance safety and minimize morbidity and costs of this valuable procedure. (C) 2002 Elsevier Science Ltd. All rights reserved.