Peripheral blood (PB) CD34+ cells enumeration is currently the most reliable method to guide the timing of stem cell harvest. However, its usage is restricted by being technically challenging, costly, and time-consuming. Immature reticulocyte fraction (IRF) determination, which is simpler and cheaper and has a faster turn-around time, has been proposed for a similar purpose. The purpose of this study is to evaluate the value of IRF in guiding stem cell harvest and examine the correlation between IRF and PB CD34+ cells count. Daily pre-harvest tests, i.e. PB CD34+ cells and IRF from 21 patients scheduled for autologous PBSC transplant were assessed. Stem cells harvests were commenced when the PB CD34+ cell count were more than 10 cell/ul. A total of 205 pre-harvest tests were analysed. Following stem cell mobilisations, both the IRF and PB CD 34+ cell counts rose with a variable pattern. In this study, we observed that the IRF peaks preceded the PB CD34+ count by 2 days. On the day of stem cell harvest, all the peak IRF values were >0.3. The PB CD34+ cell counts correlated with the harvested stem cell yield, whereby r2 = 0.77, p < 0.021. In autologous stem cell mobilisation, we believe that IRF is a useful screening tool to predict the rise of the PB CD34+ cell counts as it is a simple, fast and less costly. An IRF of > 0.3 may be used as a cut-off value for the initiation of PB CD34+ quantifi cation prior to stem cell harvest.
Peripheral Blood Stem Cell Transplantation ; Hematopoietic Stem Cells

Thrombotic thombocytopenic purpura (TTP) is a serious complication following stem cell trans-plantation (SCT). Although therapeutic plasma exchange offers an encouraging treatment modality in classic TTP, this does not appear to be effective in its management of TTP following SCT. This patient with malignant lymphoma developed TTP two months after autologous peripheral blood SCT and was effectively treated with plasma exchange and steroid therapy. Plasma exchange with fresh frozen plasma and albumin was performed 14 times in 40 days. Even though TTP may emerge as a complication of autologous peripheral blood SCT, this report suggests that the risk of developing TTP after autologous peripheral blood SCT may be low and a multiple course of plasma exchange may be an effective treatment in this patient.
Humans ; Lymphoma ; Peripheral Blood Stem Cell Transplantation* ; Plasma ; Plasma Exchange ; Purpura ; Purpura, Thrombotic Thrombocytopenic* ; Stem Cells

Generation of various autoantibodies and associated autoimmune diseases has been reported in allogeneic and autologous stem cell transplant recipients. We report a case of scleroderma following autologous peripheral blood stem cell transplantation.
Autoantibodies ; Autoimmune Diseases ; Peripheral Blood Stem Cell Transplantation* ; Stem Cells ; Transplantation

BACKGROUND: Peripheral blood stem cell transplantation (PBSCT) has been widely used as a substi-tute of bone marrow transplantation for the treatment of various solid tumors or hematologic malig-nancies. The success of PBSCT is correlated with peripheral blood CD34+ cell count per kilogram of the recipient body weight. Standardization of flow cytometric CD34+ cell enumeration was improved by the modified International Society of Hematotherapy and Gene Engineering (ISHAGE) protocol. The purpose of this study was to evaluate the peripheral parameters (WBCs, mononuclear cells, the CD 34+ cells) that may predict the total CD34+ cell count in the harvest product, using the Stem-Kit (Beck-man Coulter Inc., Fullerton, CA, USA). METHODS: The study tested 88 PBSC harvests and peripheral blood (PB) on the day before collection from 26 patients. The CD34+ cells were analyzed using the Stem-Kit. The WBC and MNC count were measured by Coulter STKS (Beckman Coulter Inc.). The correlation and regression analysis between peripheral parameters (WBCs, MNCs, CD34+ cells) and the total CD34+ cell count in the harvest product were performed. RESULTS: The CD34+ cell count per weight (kg) of 88 PBSC harvests was 1.59 +/- 2.61 (0.01 -17.35). The mean number of WBC, MNC, and CD34+ cell in PB prior to harvest were 10.57 +/- 8.36 (1.50 - 32.50) X 10(3)/micro L, 1.85 +/- 1.28 (0.39- 7.43) X 10(3)/micro L, and 17.21 +/- 33.19 (0.12-239.19)/micro L, respectively. With the CD34+ cells numbering under 3/micro L in peripheral blood (PB), we could not harvest more than 0.5 X 10(6) /kg PBSC. With the cells numbering 3-6/micro L (59%) and 10- 20/micro L (89%), however, we could harvest more than 0.5 X 10(6) /kg and 1.0 X 10(6) /kg, respectively. More than 2.0 X 10(6)/kg of PBSC was collected with 10-20/micro L (31%). The peripheral blood CD34+ cell count prior to harvest significantly correlated with the total CD34+ cell count in the harvest product (r=0.97, P<0.05). CONCLUSIONS: Peripheral blood CD34+ cell enumeration using the Stem-Kit was an efficient predictor of when to harvest peripheral blood stem cells after mobilization therapy. We could not collected the CD34+ cell in harvest product of more than 0.5 X 10(6)/kg if the peripheral blood CD34+ cell count was less than 3/micro L.
Body Weight ; Bone Marrow Transplantation ; Cell Count* ; Humans ; Peripheral Blood Stem Cell Transplantation ; Stem Cells*

OBJECTIVE: To analyze the factors influencing the mobilization of autologous peripheral blood stem cells (auto-PBSCs) in patients with lymphoma and multiple myeloma, and provide reference for optimizing the autologous stem cell mobilization regimen. METHODS: Clinical data of 33 multiple myeloma and lymphoma patients received auto-PBSCs mobilization in our center from January 2015 to December 2018 were collected, the correlation of mobilization failure rate with gender, age, courses of chemotherapy before mobilization, does of recombinant human granulocyte colony stimulating factor (rhG-CSF), type of disease, and chemotherapy regimen were retrospectively analyzed. RESULTS: Type of disease and course of pre-mobilization chemotherapy could affect the mobilization failure rate (P<0.05). The mobilization failure rate of lymphoma patients was 42.1%, which was significantly higher than 7.1% of multiple myeloma patients (P=0.026). The mobilization failure rate was higher in the group with chemotherapy courses≥5 before mobilization (P=0.016). Age, gender, dose of rhG-CSF, and chemotherapy regimen had no significant correlation with mobilization failure rate (P>0.05). CONCLUSION Multi-course chemotherapy before collection and lymphoma patients are poor factors negatively impacting on auto-PBSCs mobilization.
Hematopoietic Stem Cell Mobilization ; Humans ; Lymphoma/therapy* ; Multiple Myeloma/therapy* ; Peripheral Blood Stem Cells ; Retrospective Studies

PURPOSE: In children, at least two or more stem cell mobilization processes are needed in autologous peripheral blood stem cell transplantation to prevent delayed engraftment. And to decrease the risk of tumor cell contaminations, the use of CD34 positive cell selcetion is in increasing tendency. The first leukapheresis product is stored overnight and undergoes CD34 positive selection process mixed with the next day leukapheresis product to save the costs. We intended to find out the optimal overnight storage condition that might minimize the loss of stem cell components. METHODS: RBC (red blood cell)- depleted human umbilical cord bloods (UCB) were used as the source of stem cells because of their easy availability. UCB were processed by isolating the mononuclear cell (MNC) layer using Ficoll-Paque to make the nature similar to leukapheresis products. Fifteen individual UCB were analyzed by several parameters (MNC count and viability, live CD34 positive cell fraction, clonogenic potential) at fresh conditions and under four different overnight storage conditions (room temperatiure (RT), room temperature with autoplasma (AP), 4degrees C, 4degrees C with autoplasma). Analysis of variance, Kruskal-Wallis test, and Wilcoxon signed rank test were used for statistical analyses. RESULTS: Though MNC counts were statistically not different between each conditions (P=0.07), the best recovery (mean 86.9%) was observed at 4degrees C with AP but without statistical significance. MNC viability decreased at RT with or without AP (P<0.05). On the other hand, no difference in MNC viability was noted at 4degrees C with or without AP (P> 0.05). Live CD34 positive cell fractions were significantly decreased under all four different storage conditions compared with fresh ones. However, the samples stored at 4degrees C showed less prominent decreases in live CD34 positive cell fractions than those of RT conditions irrespective of the presence of AP (P=0.0001). CONCLUSION: It seems that 4degrees C condition is superior to RT when short term storage of stem cell products is mandatory. The addition of AP seemed to be advantageous but without statistical significance. The overnight storage of stem cell products at 4degrees C seems to be mandatory because it offers relatively high recovery and less loss of stem cell components. Although the effect of AP was statistically not significant, the role of AP should be studied further because there was a tendency of higher recovery of stem cells in the presence of AP.
Cell Survival* ; Child ; Fetal Blood* ; Hand ; Hematopoietic Stem Cell Mobilization ; Humans ; Leukapheresis ; Peripheral Blood Stem Cell Transplantation ; Stem Cells

OBJECTIVEThis study was to identify the efficacy of -80°C cryopreservated peripheral blood hemato-poietic stem cell (PBHSC) transplantation for hematopoietic reanstitution in patients.

METHODSThe efficacy of 104 patients underwent autologous peripheral blood hematopoietic stem cell transplantation using uncontrolled-rate freezing and storage at -80°C was evaluated.

RESULTSThis cryopreservation method could effectively cryopreserve peripheral blood stem cells. Out of 104 patients only 2 patients died, other patients got hematologic reconstition satisfactorily, the median engrafement times of neutrophils and platelet were 12 and 14 days respectively, the activity of cells after rehabilitation was 94%, the mean recovery rates of CD34(+) cells and mononuclear cells (MNC) were 86% and 80.3% respectively. There were no significant influences on engrafement time in sex, chemotherapy circles and radiotherapy. The engrafement of leukocytes associated with amount of CD34(+) cells.

CONCLUSIONThis simple uncontrolled-rate freezing PBHSC at -80°C is safe, effective and economic, and can meet clinical needs. As compared with the classical cryopreservation, there were no significant differences in hematopoietic reconstitution. Therefore, this method worth to popularize and apply in clinic.

The dose of CD34+ cells is known to influence the outcome of allogeneic peripheral blood stem cell (PBSC) and/or T-cell-depleted transplantation. A previous study proposed that 2×10⁶ CD34+ cells/kg is the ideal minimum dose for allogeneic transplantation, although lower doses did not preclude successful therapy. In the case we present here, CD34+ cells were collected from a matched sibling donor on the day of allogeneic hematopoietic stem cell transplantation; however, the number of cells was not sufficient for transplantation. Consequently, PBSCs were collected three additional times and were infused along with cord blood cells from the donor that were cryopreserved at birth. The cumulative dose of total nuclear cells and CD34+ cells was 15.9×10⁸ cells/kg and 0.95×10⁶ cells/kg, respectively. White blood cells from this patient were engrafted on day 12. In summary, we report successful engraftment after infusion of multiple low doses of CD34+ cells in a patient with severe aplastic anemia.
Anemia, Aplastic ; Cord Blood Stem Cell Transplantation ; Fetal Blood ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukocytes ; Parturition ; Peripheral Blood Stem Cell Transplantation ; Siblings ; Stem Cells ; Tissue Donors ; Transplantation, Homologous

BACKGROUND: The hematopoietic stem cell bank has been actively recruiting registrants since 1994. This study systematically reviews its operations and outcomes over the last 20 years. METHODS: Retrospective data on a total of 47,711 registrants were reviewed. Relevant data were processed using PASW Statistics for Windows, version 18.0. RESULTS: As of 2013, the Korean Network for Organ Sharing database contained 265,307 registrants. Of these, 49,037 (18%) registrants committed to hematopoietic cell donation from 1994 to 2013. Fifty-seven percent of the registrants were men, and 43% were women. The reasons for opting out of the registry included refusal to donate (70%), family refusal (28%), and others (2%). The donation willingness of registrants was significantly higher than those who refused to receive a mail to confirm their continued enrollment (χ2=6.103, P=0.013). The bank successfully coordinated a total of 512 donors among newly matched donors from 1995 to 2013, of which the bone marrow and peripheral blood stem cell accounted for 40.8% and 59.2% of the total donations, respectively. CONCLUSION: Our recruitment activities focus on promoting voluntary registration and the importance of updating personal contact information. We expect that these data may be useful for diverse studies and demonstrate the positive impacts on the donation program.
Bone Marrow ; Bone Marrow Transplantation ; Female ; Hematopoietic Stem Cells* ; Humans ; Male ; Peripheral Blood Stem Cell Transplantation ; Personnel Selection ; Postal Service ; Retrospective Studies ; Stem Cells ; Tissue Donors

PURPOSE: Cryopreservation of hematopoietic stem cells is one of the essential components in autologous and peripheral blood stem cell transplantation. Cryopreservation of hematopoietic stem cell, the conventional method involves controlled-rate freezing by a programmed freezer in medium that contains 10% dimethyl sulfoxide (DMSO) as cryoprotectant, followed by storage in liquid nitrogen freezer. We compared the differences between different methods of cryopreservation and cryoprotectants on viability and colony forming capacity of hematopoietic stem cells. METHODS: Mononuclear cells separated using Ficoll-Hypaque from cord blood, peripheral blood and bone marrow were frozen with programmed freezer at 196degrees C or placed in a 70degrees C freezer without programmed freezer in both 10% and 20% DMSO. We measured cell viability using trypan blue dye exclusion method and colony forming capacity with methyl cellulose media at 7, 30 and 90 days after thawing. RESULTS: Cell viability of cord blood, peripheral blood and bone marrow was higher in the groups with programmed freezer compared with rapid freezing and storing in a 70degrees C freezer. Also as the storage time passed, the decrease in viability of hematopoietic cells was much less in the groups of controlled-rate freezing by a programmed freezer. The number of colony in cord blood and bone marrow was higher with programmed freezer and that of peripheral blood was higher with rapid freezing and storage in a 70degrees C freezer. Comparing the differences between different concentraions of DMSO, cell viability was similar or slightly higher in 20% DMSO groups than 10% DMSO groups, but the number of colony was higher in 10% DMSO groups. CONCLUSION: These results suggested that conventional cryopreservation method using programmed freezer with 10% DMSO was more effective in the cryopreservation of hematopoietic stem cells.
Bone Marrow ; Cell Survival ; Cryopreservation* ; Dimethyl Sulfoxide ; Fetal Blood ; Freezing ; Hematopoietic Stem Cells* ; Methylcellulose ; Nitrogen ; Peripheral Blood Stem Cell Transplantation ; Stem Cell Transplantation ; Trypan Blue