The CD 34 count at harvest

[Liz]

What is the minimum peripheral blood CD34 count at which you would perform an autologous PBSC harvest, for adults and for pediatrics?

Thank you

Liz

[CM2]

At our institution (adult transplant only) the stated acceptable peripheral CD34 count is 10. Only patients who have to be mobilized off of chemo in combination with gcsf get peripheral counts to determine harvest timing. "Normal" patients mobilized on gcsf alone do not get counts, they simply get collected starting on day 4 gcsf. Our donor program is often browbeaten into collecting at a 6 or 8 peripheral CD34 because "We're sure it will be higher tomorrow". From a processing lab standpoint it seems that results in an unnecessary day of harvest 75% of the time, but there is that minority of patients with extensive pretreatment (revlamid/irradiation) where you end up needing every scrap collected. Judgement of your transplant coordinator/medical director is needed to determine those exceptions where it will be worthwhile for the patient.

[Liz]

Yes the Oncologists decide. I am glad to know that you have a similar scenario, I was getting complaints from the operators, now I see that what was thought "abnormal" is actually "normal".

We collect below peripheral CD34 count of 20 although 20 is our cut-off.

I understand collecting every bit that we can.

I usually argue that I want a pre-collection peripheral count and dont get it, I see you dont. And we have at times collected before the peak too, but also at times we were not informed and missed the peak, thus my incident reports.

Thanks its good to know I am not alone.