Analysis of the effect of prior therapy on progenitor cell yield: use of a chemotherapy scoring system

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Abstract
A quantitative analysis of peripheral blood stem cell (PBSC) yield, measuring absolute numbers of CD34+ cells × 106/kg and CFU‐C × 104/kg was performed in 74 consecutive patients. The interval or ‘gap’ from the end of previous chemotherapy to the date of priming was recorded in weeks. Geometric mean CD34 and CFU‐C values were significantly higher in patients with a score of ≤ 60 compared to those with score > 60 (P = 0.003 and 0.02, respectively) and a significant difference in CD34 values was also found when scores of ≤ 38 were compared with scores > 38 (P = 0.003), with the difference in CFU‐C values approaching significance (P = 0.08). Patients exposed to toxicity factor 4 drugs had significant lowering of both CD34 and CFU‐C values (P < 0.001 and P = 0.038) and this emerged as the only independent factor when analysed using linear regression. No significant difference in the geometric mean CD34 or CFU‐C values of patients was found in any of the gap categories analysed. Prior exposure to toxicity factor 4 drugs had a significant adverse effect on stem cell yield and should be avoided or minimized prior to stem cell harvesting.

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