Effect of Mobilization Methods on CD34+ and Total Nucleated Cell Count and Their Relation with Engraftment in Autologous Hematopoietic Stem Cell Transplantation

INTRODUCTION: Effective stem cell mobilization is crucial for autologous hematopoietic stem cell transplantation (auto-HSCT), impacting engraftment time and patient outcomes. This study compared three mobilization regimens (G-CSF alone, G-CSF & plerixafor, and chemotherapy & G-CSF) to determine their optimal use for maximizing CD34+ cell yield and minimizing engraftment times.
METHODS: A retrospective analysis of 227 auto-HSCT patients was conducted. Mobilization groups, CD34+ cell counts, total nucleated cells (TNC), total mononuclear cells (TMNC), and platelet/neutrophil engraftment times were analyzed.
RESULTS: The average engraftment time was 11.6 days for platelets and 10.6 days for neutrophils. The chemotherapy & G-CSF arm yielded the highest CD34+ cells (p=0.001) and lowest TNC/TMNC (p=0.000). This arm also achieved the fastest platelet engraftment (p=0.017-0.001). Notably, age positively correlated with TNC count (p=0.022) and prolonged neutrophil engraftment (p=0.021). Gender did not significantly influence engraftment times.
DISCUSSION AND CONCLUSION: The chemotherapy & G-CSF regimen yielded the highest CD34+ cell count, lowest TNC/TMNC, and fastest platelet engraftment. However, neutrophil engraftment was positively associated with age, suggesting additional factors influence this outcome. Optimizing mobilization strategies and considering patient age are crucial for optimizing auto-HSCT outcomes.