[CD 34 count in the Collect]

For single adult transplants, the MDs request 3 million CD34 per kg (ABW). Myeloma patients the endpoint is 6 million. Our docs have worked out an algorithm for the requested endpoint and circulating CD34 to determine when to start collections. It generally works well except for the infrequent poor mobilizer.

Peds generally want 3-5 million unless it's for a neuroblastoma patient - that usually means 10-15 million per kg. Most kids mobilize very well so the higher dose isn't a problem.

[Stem Cell Discard and storage Dilemma]

We are an active transplant facility transplanting approximately 140 patients per year - allogeneic, autologous, unrelated - PBSC, marrow and cord blood. We've run out of storage room for frozen products which consist mainly of autologous peripheral collections and aliquots of CD3 cells for potential DLI. We are accredited by FACT, CAP, and AABB and need to rework our storage policies so that we can continue to grow with the program and have room for new patients. What are other facilities using as their storage duration and how do you get the physician to agree to discard after the storage period is up (even when they signed the agreement initially and the patient wants to discard)? FACT requires an option to transfer the cells to another facility for storage after the storage period is over - where is this magical facility? Does anyone have any information about facilities that offer long-term storage for stem cells (hopefully accredited?)?

Looking for ideas and help.

[CFU assays on proficiency surveys]

CFUs are usually report per 100,000 cells plated. You can make a dilution of 20,000 cells/ml and multiple the answer by five. Many people do that to make the plates readalbe.

Sarah

We've done it that way and it seems that the calculation multiplies 5 fold any inherent "errors" in counting - so it's easy to go out of the 2 or 3 SDI that they use for "passing". That's why we suffer with the 50,000 cells/ml which is only multiplied by a factor of 2 even though it is more difficult to read. We have a better track record doing it that way.

[CFU assays on proficiency surveys]

It warms my heart to know that other real people have problems with these tests, too! I cringe every time we send results in - we've done both CAP and StemCell technologies and of the two, StemCell Technologies seemed to be better since we followed their instructions. The difficulty for us is that the results are reported as colonies per 100,000 cells - we plate at numbers much lower - 20,000 cells - because it makes the plates easier to evaluate and enumerate. For the PT samples, we try not to plate lower that 50,000 cells per ml. We cannot plate at 100,000 cells/ml or the plates would be un-readable. There's a reason that it takes 6 months for CAP to post the evaluations- there seems to be little concensus for CFU. This probably didn't help you with your problem but it sure did make me feel a little better.