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Peripheral blood CD34+ peak during mobilisation as an additional parameter to assess PBSC inoculum adequacy autologous HSCT

Year: 2026

Type: article

Abstract: Background: After autologous haematopoietic stem cell transplantation (HSCT), the infused CD34+ cell dose is usually considered essential for assessing the adequacy of the peripheral blood progenitor cells (PBSC) inoculum. Methods: In a cohort of 302 patients who underwent autologous haematopoietic transplantation, we investigated whether the peak peripheral blood CD34+ cell count during mobilisation could predict neutrophil engraftment. Results: In the overall cohort, the mean time to neutrophil engraftment was 12.2 days, and the mean infused CD34+ cell dose was 5.1 × 10^6 CD34+ cells/kg. In univariate analysis, the CD34+ cell dose (p=0.005), the PB CD34+ peak during mobilisation (p=0.0002), the number of performed apheresis (p=0.03), and the use of G-CSF (p=0.001) were significantly associated with time to neutrophil engraftment. When factors were evaluated in multivariate analysis, the PB CD34+ peak and use of G-CSF remained significant. In a ROC analysis, the PB CD34+ peak predicted delayed engraftment with an AUC of 0.695 (95% CI, 0.599-0.791). Joint stratification by PB CD34+ peak and infused CD34+ dose identified subgroups at high risk of delayed engraftment. Conclusion: In patients treated by autologous HSCT and receiving an adequate dose of infused CD34+ cells, the PB CD34+ peak during mobilisation is independently associated with post-transplant neutrophil engraftment.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1935217