A mathematical model for predicting blood volume to be processed for optimizing peripheral blood CD34+ cell yield during stem cell apheresis

Rattaporn  Vichitratchaneekorn; Kanokpol  Siriphanthong; Kanokwan  Chinbordee; Phandee  Watanaboonyongcharoen; Ponlapat  Rojnuckarin

Authors

Rattaporn Vichitratchaneekorn Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Kanokpol Siriphanthong Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Kanokwan Chinbordee National Blood Centre, Thai Red Cross Society, Thailand
Phandee Watanaboonyongcharoen Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand and Renal Immunology and Renal Transplant Center of Excellence, Chulalongkorn University, Bangkok, Thailand
Ponlapat Rojnuckarin Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Hematopoietic stem cell transplantation, peripheral blood stem cell apheresis, precollection CD34+ cell counts

Abstract

Background: Accurately predicting stem cell yields is important for planning peripheral blood stem cell (PBSC) collection.

Objective: This study aimed to develop a formula to forecast the blood volume required to process CD34+ cells to ensure adequate products.

Methods: Data from donors and patients who underwent PBSC apheresis at a tertiary care hospital were reviewed. BD FACSCanto™ II and Navios EX Flow Cytometry machines were used to determine the precollection CD34+ cell counts (pre-CD34).

Results: In 50 donors and 85 patients, 145 leukapheresis procedures were performed. Linear regression models accurately predicted the absolute CD34+ cell yields from pre-apheresis values, supporting the optimal planning of the procedure. Subgroup analysis identified gender, but not body weight, as a significant factor influencing collection efficiency, with lower yields in females. To ensure adequate stem cell yield, genderspecific formulas were derived to calculate the required blood volume processing. For males: Volume process (L) = (Dose CD34 [106cells/kg] * body weight recipient [kg] + 21)/ 0.44 * PreCD34 (cells/μL); For females: Volume process (L) = (Dose CD34 [106Cells/kg] * body weight recipient [kg]) – 48)/0.28 * PreCD34 (cells/μL). Furthermore, a strong correlation (r = 0.981) was observed between the two enumeration platforms, with Bland-Altman analysis confirming minimal bias and narrow variability. No significant variation in preCD34 was detected.

Conclusion: Applying preCD34 count and gender-specific predictive modeling offers valuable tools to enhance procedural efficiency and generate appropriate processed volume for the collection of adequate quantities of stem cells. Furthermore, the significance of standardizing CD34+ enumeration methods was underscored.

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