search for


Original Article
Differences in Mobilization Efficiency between Small Children and Adults with Healthy Marrows
Clin Pediatr Hematol Oncol 2017;24:130-5.
Published online October 31, 2017
© 2017 Korean Society of Pediatric Hematology-Oncology and Korean Society for Pediatric Neuro-Oncology

Eun-kyung Shin, M.D.1, Do-Yeon Kim, M.D.1, Wee-Jin Rah, M.D.1, Hani Koh, M.D.1,2, Jin Young Suh, B.S.2, Misoo Chang, M.S.3, Eunwoo Nam, Ph.D.3 and Young-Ho Lee, M.D., Ph.D.1,2

1Department of Pediatrics, 2Blood and Marrow Transplantation Center, 3Biostatistical Consulting and Research Lab, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea
Correspondence to: Young-Ho Lee
Department of Pediatrics, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
Tel: +82-2-2290-8383 Fax: +82-2-2297-2380 E-mail: 
Received September 25, 2017; Revised October 7, 2017; Accepted October 17, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: We compared the yields of mobilized PBSCs from single day of normal volume leukapheresis (NVL) in children and adults, and factors affecting the yields, to understand differences in mobilization efficiency between adults and small children with healthy marrows.Methods: This study involved 18 adult volunteer donors and 47 small children weighing less than 20 kg who participated in a clinical trial of cell therapy in children with cerebral palsy. Donor factors analyzed to identify predictors of the yield of apheresis included age, gender, weight and complete blood cell count (CBC) with differential counts as well as equipment parameters. Results: The yields of total nucleated cells (TNCs) and CD34cells in the apheresis products of the children were significantly lower than in those from healthy adults. However, the efficiency of recovery of PBSCs (total CD34 cell counts/TNCs) was significantly higher in small children (0.48±0.30%) than in adults (0.10±0.05%) (P<0.05). Multivariable analysis of adult donor factors showed that the processed volume and flow rate of apheresis were significantly associated with the yield of TNCs (P<0.05, for both), but not of CD34cells. However, in multivariable analysis of child donor factors, body weight and circulating WBC count on the day of apheresis were significantly associated with the yield of TNCs (P<0.05, for both) and of CD34cells (P<0.05, for both).Conclusion: The predictors of PBSC yields from a single day of NVL in adults and small children are different. Also mobilization is more effective in small children than in adults.
Keywords: Peripheral blood stem cell, Hematopoietic stem cell mobilization, Efficacy, Predictor, Children, Adults
  1. Mavroudis D, Read E, Cottler-Fox M, et al. CD34+ cell dose predicts survival, posttransplant morbidity, and rate of hematologic recovery after allogeneic marrow transplants for hematologic malignancies. Blood 1996;88:3223-9.
  2. Pulsipher MA, Chitphakdithai P, Logan BR, et al. Donor, recipient, and transplant characteristics as risk factors after unrelated donor PBSC transplantation: beneficial effects of higher CD34+ cell dose. Blood 2009;114:2606-16.
    Pubmed KoreaMed CrossRef
  3. Nakamura R, Auayporn N, Smith DD, et al. Impact of graft cell dose on transplant outcomes following unrelated donor allogeneic peripheral blood stem cell transplantation: higher CD34+ cell doses are associated with decreased relapse rates. Biol Blood Marrow Transplant 2008;14:449-57.
    Pubmed KoreaMed CrossRef
  4. Hölig K, Kramer M, Kroschinsky F, et al. Safety and efficacy of hematopoietic stem cell collection from mobilized peripheral blood in unrelated volunteers: 12 years of single-center experience in 3928 donors. Blood 2009;114:3757-63.
  5. Stroncek DF, Clay ME, Jaszcz W, Lennon S, Smith J, McCullough J. Collection of two peripheral blood stem cell concentrates from healthy donors. Transfus Med 1999;9:37-50.
    Pubmed CrossRef
  6. Wang TF, Wen SH, Chen RL, et al. Factors associated with peripheral blood stem cell yield in volunteer donors mobilized with granulocyte colony-stimulating factors: the impact of donor characteristics and procedural settings. Biol Blood Marrow Transplant 2008;14:1305-11.
    Pubmed CrossRef
  7. Vasu S, Leitman SF, Tisdale JF, et al. Donor demographic and laboratory predictors of allogeneic peripheral blood stem cell mobilization in an ethnically diverse population. Blood 2008; 112:2092-100.
    Pubmed KoreaMed CrossRef
  8. Suzuya H, Watanabe T, Nakagawa R, et al. Factors associated with granulocyte colony-stimulating factor-induced peripheral blood stem cell yield in healthy donors. Vox Sang 2005;89: 229-35.
    Pubmed CrossRef
  9. Pulsipher MA, Levine JE, Hayashi RJ, et al. Safety and efficacy of allogeneic PBSC collection in normal pediatric donors: the pediatric blood and marrow transplant consortium experience (PBMTC) 1996-2003. Bone Marrow Transplant 2005;35:361-7.
    Pubmed CrossRef
  10. Rujkijyanont P, Hipps J, Gan K, et al. Prediction of CD34(+) cell yield in hematopoietic cell products from children by peripheral blood CD34(+) cell counts. Cytotherapy 2012;14: 473-82.
    Pubmed CrossRef
  11. Yoon WS, Kook H, Kim CJ, Park A, Ryang DW, Hwang TJ. Peripheral blood stem cell collection and engraftment kinetics in pediatric patients Korean J Pediatr Hematol Oncol 1999;6: 330-8.
  12. Abrahamsen JF, Stamnesfet S, Liseth K, Hervig T, Bruserud O. Large-volume leukapheresis yields more viable CD34+ cells and colony-forming units than normal-volume leukapheresis, especially in patients who mobilize low numbers of CD34+ cells. Transfusion 2005;45:248-53.
    Pubmed CrossRef
  13. Fontana S, Groebli R, Leibundgut K, Pabst T, Zwicky C, Taleghani BM. Progenitor cell recruitment during individualized high-flow, very-large-volume apheresis for autologous transplantation improves collection efficiency. Transfusion 2006;46:1408-16.
    Pubmed CrossRef
  14. Bojanic I, Mazic S, Rajic L, Jakovljevic G, Stepan J, Cepulic BG. Large volume leukapheresis is efficient and safe even in small children up to 15 kg body weight. Blood Transfus 2016; 15:85-92.
  15. Bone marrow, thymus and blood: changes across the lifespan. Aging Health 2009;5:385-93.
    Pubmed KoreaMed CrossRef
  16. Petit I, Szyper-Kravitz M, Nagler A, et al. G-CSF induces stem cell mobilization by decreasing bone marrow SDF-1 and up-regulating CXCR4. Nat Immunol 2002;3:687-94.
    Pubmed CrossRef
  17. Lévesque JP, Hendy J, Takamatsu Y, Simmons PJ, Bendall LJ. Disruption of the CXCR4/CXCL12 chemotactic interaction during hematopoietic stem cell mobilization induced by GCSF or cyclophosphamide. J Clin Invest 2003;111:187-96.
  18. Lévesque JP, Hendy J, Takamatsu Y, Williams B, Winkler IG, Simmons PJ. Mobilization by either cyclophosphamide or granulocyte colony-stimulating factor transforms the bone marrow into a highly proteolytic environment. Exp Hematol 2002;30:440-9.
  19. Winkler IG, Hendy J, Coughlin P, Horvath A, Lévesque JP. Serine protease inhibitors serpina1 and serpina3 are down-regulated in bone marrow during hematopoietic progenitor mobilization. J Exp Med 2005;201:1077-88.
    Pubmed KoreaMed CrossRef
  20. Semerad CL, Christopher MJ, Liu F, et al. G-CSF potently inhibits osteoblast activity and CXCL12 mRNA expression in the bone marrow. Blood 2005;106:3020-7.
    Pubmed KoreaMed CrossRef
  21. Lee YH, Lee YA, Noh KT, et al. Homing-associated cell adhesion molecules and cell cycle status on the nucleated cells in the bone marrow, mobilized peripheral blood and cord blood. J Korean Med Sci 2004;19:523-8.
    Pubmed KoreaMed CrossRef

October 2018, 25 (2)
Full Text PDF
Send to a friend

Cited By Articles
  • CrossRef (0)

Author ORCID Information
  • Young-Ho Lee 

Funding Information