[MichelP]

Enough Stem cells for two SCT?

by MichelP on Sat Nov 05, 2011 8:14 pm

Hello all,

I've just completed two days of Stem cells collection and I am a bit concerned that there was not enough stem cells collected for two SCT.

First a bit of background; I had 5 cycles of induction therapy called CyBorD (Velcade, Cyclophosphamide/Decadron) to which I seem to have responded well. Then last week I received High dose Cyclophosphamide & Decadron and started Neupogen Injection. Over the last weekend I became neutropenic and started to have a high fever so I was admitted to the hospital for four days while I received antibiotics all the while continuing the Neupogen injections. I was released on Thursday.

On Friday had the first tem cell collection on wich they collected about 3 million stem cells. I was asked to return the next day (that is today) and was informed that they collected only 1.15 million cells for a total of 4.15 miillion. I was also informed that my CD34 counts were actually dropping despite the fact that I continued the injections of Neupogen as of last night.

My questions are the following: Is this enough for more than one transplant and if not, can the collection procedure be repeated after an SCT? I am scheduled to have one within the next three weeks.

I will nor have access to my doctor until a few more days and I would sleep better knowing the answer to these questions.

Thanks in advance

[rumnting]

Re: Enough Stem cells for two SCT?

by rumnting on Sun Nov 06, 2011 7:25 pm

When my husband had his done last month, we were told that sometimes a SCT is done with only 4 million cells. I do not think you have enough collected for two SCTs. My husband was also told that if his stem cell levels were not high enough from the Neupogen, that there would be another drug added (I don't remember the name of it). I'm sure an MD will jump on tomorrow, and give you a much more informative response.

[Dr. Edward Libby]

Re: Enough Stem cells for two SCT?

by Dr. Edward Libby on Mon Nov 07, 2011 1:00 pm

Hello Michel,

The general recommendation for the number of stem cells required to perfom an autologous stem cell transplant is 2 miilion cells per kilogram of body weight. This is the threshold to allow a prompt and persistent hematopoietic recovery. Most transplant MDs would prefer to have more cells ( e.g. 3-5 million/kg body weight) but it is not uncommon to have lower numbers. Transplants can be done successfully with even lower numbers of stem cells but the chances of having rapid engraftment and excellent (normal) blood counts after transplant are reduced.

Yes, you can recollect a patient after a poor initial mobilzation or even a previous stem cell transplant for myeloma. One can repeat the mobiliation attempt with a different growth factor, using different collection techniques on the leukapheresis machine or using the new drug Mozibil. Mozibil has shown significant efficacy in patients who have poor initial collections (these patients had not yet had a transplant ).

Less is known regarding recollections in patients who have received high dose melphalan during a previous stem cell transplant. One would expect that a recollection after transplant would yield significanlty lower numbers of stem cells.

[MichelP]

Re: Enough Stem cells for two SCT?

by MichelP on Mon Nov 07, 2011 3:49 pm

Hello Dr. Libby,

Thanks for taking the time to respond. It is much appreciated.

Best regards,