Optimal Time For Pbsc Collection

The timing of PBSC collection is important in order to maximize the number of progenitors harvested. Using growth factor alone for mobilization, apheresis is usually performed on days 5, 6, and 7 of G-CSF administration. Progenitor cell levels start to decrease after day 8 even with continuation of G-CSF. Following chemotherapy mobilization, it is recommended to start PBSC collection at 12-14 days after chemotherapy when WBC >1 X 109/L.47 For chemotherapy + growth factor mobilization, apheresis usually starts when the WBC reaches 2-5 X 109/L. However, some studies suggest that a delay in PBSC collection until WBC >10 X 109/L may be more optimal. A strong linear relationship between the number of CFU-GM and CD34+ cells in both the leukaphresis product and PB on the day of collection has been well established. Several studies have shown that the number of circulating CD34+ cells predicts the extent of PBSC collection and may be used to anticipate or delay leuka-pheresis, as well as to shorten or extend the duration of procedure. At present CD34+cells measurement is preferable since it is a more direct measurement of progenitor cells, and it should be used to guide stem cell collection.48

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