Predicting the CD34 content of mobilized peripheral blood leukapheresis products: Single institution experience over 20 years

• Published in: Cytotherapy (Oxford, England) England), 2024-02, Vol.26 (2), p.171-177
• Main Authors: Mutlu, Yaşa G., Sevcik, Joan, Kiss, Joseph E., Lister, John, Moore, Linda R., Donnenberg, Albert D.
• Format: Article
• Language: English
• Subjects: CD34; flow cytometry; Leukapheresis; mobilization; predictor
• ISSN: 1465-3249; 1477-2566
• DOI: 10.1016/j.jcyt.2023.09.005

•Performance of an empirical multivariate algorithm to predict leukapheresis CD34 yield was tracked in a single institution over 20 years, providing a definitive assessment of performance.•The algorithm was stable with high sensitivity (97.7%) and specificity (81.4%) over a 13-yr period but required revision when Cobe Spectra leukapheresis instruments were replaced with the automated Terumo Spectra Optia system.•The relative merits of two different approaches to CD34 prediction (physical versus empirical) are discussed in Supplemental Materials, with practical examples. Since the standardization of CD34 measurement by flow cytometry, predictors of leukapheresis CD34 yield have played a pivotal role in planning donor leukaphereses. We describe here a single institution's experience with a multivariate predictor that was used for 2,929 products without alteration for 20 years. The model variables included log peripheral CD34 count, collection duration (3- versus 4-hours), collection number, donor sex, and transplant type. During the study period we changed flow cytometers twice and leukapheresis instruments once. During the Cobe Spectra era the predictor explained 90% of the variability in CD34 collection yield for autologous transplants (r2 = 0.90), and 70% for allogeneic transplants with an overall sensitivity to predict a CD34 yield of ≥ 1 × 106/kg of 97.7%, and specificity of 81.4%. Implemented prospectively with real-time result reporting, the model allowed us to predict CD34 yield with both 3- and 4-hour collection scenarios. Given this guidance, 3-hour collections were selected by the clinical team 25% of the time, saving patient leukapheresis time and resources. When faced with a prediction of < 1 × 106 CD34/kg, the clinical team chose to defer collection 72% of the time. In instances where leukapheresis was performed despite a poor predicted outcome, 85% of patients collected on the Cobe Spectra, and 92% of patients collected on the Optia, failed to collect at least 1 × 106 CD34/kg. A revised model and suggestions for further improvements are discussed. [Display omitted]