Congress Abstracts 2004

53

STEADY STATE CD34+ CELL ENUMERATION: IMPLEMENTING A PRACTICAL APPROACH TO OPTIMIZING PERIPHERAL BLOOD STEM CELL COLLECTION. Donna Kane, RN, OCN^®, University Hospitals of Cleveland Ireland Cancer Center, Cleveland, OH, and Omer Koc, MD, and Pingfu Fu, PhD, Case Western Reserve University, Cleveland, OH.

Seeking a practical and direct approach to completing a task is essential in the nurse coordinator role. We have attempted to define and develop a practical guide for patients, donors, and staff when preparing for stem cell mobilization and collection.

There is a wide variability in progenitor cell yield between patients/donors undergoing stem cell mobilization. The sources of this variability include type of mobilization regimen, number of previous cycles of chemotherapy and radiation, disease type, age, gender, and biological differences in donors. Few studies have examined the role of steady state (SS) CD34+ cell enumeration as a factor for predicting progenitor cell yield. The purpose of this retrospective review was to analyze pre-mobilization SS CD34+ cell numbers in blood as a predictive factor of successful stem cell collection.

Between October 2000 and October 2002 the stem cell nurse coordinator at University Hospitals of Cleveland’s Ireland Cancer Center initiated a project examining SS CD34+ levels of 143 patients and normal donors. Demographic data was gathered including gender, age, mobilization regiment, and diagnosis.

The classification and regression tree analysis was used to come up with a predictive algorithm for successful stem cell collection. This method can generate a clinical decision-making algorithm and can often uncover complex interactions between predictors that exist in the data. Data that currently exists on the review of SS CD34+ for predicting collection was based on heterogeneous populations. Our method of analysis homogenizes the population with the algorithm. Significant associations were found between SS CD34+ cell numbers and stem cell collection yields. A SS CD34+ > 2.65/ml is associated with a high probability of a good collection. Gender, age, diagnosis, and type of mobilization therapy also influenced the collection success.

We determined that patients/donors at risk of not achieving sufficient CD34+ cell numbers for transplant can be prospectively identified. This information can be used for proper planning and counseling of patients and physicians and, if needed, alternative mobilization and stem cell collection plans can be made. The information obtained from this aggregate data review can also be used as a QM project for validation of our collection process.