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Sanikommu SR, Reese ES, He J, Lee C, Ai J, Butler CM, Jacobs R, Hu B, Atrash S, Trivedi J, Bhutani M, Voorhees P, Usmani SZ, Ghosh N, Fasan O, Druhan LJ, Symanowski J, Copelan EA, Avalos BR. Cost saving, patient centered algorithm for progenitor cell mobilization for autologous hematopoietic cell transplantation. J Clin Apher 2021; 36:553-562. [PMID: 33710672 DOI: 10.1002/jca.21892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/10/2022]
Abstract
Administration of plerixafor with granulocyte-colony stimulating factor (G-CSF) mobilizes CD34+ cells much more effectively than G-CSF alone, but cost generally limits plerixafor use to patients at high risk of insufficient CD34+ cell collection based on low peripheral blood (PB) CD34+ counts following 4 days of G-CSF. We analyzed costs associated with administering plerixafor to patients with higher day 4 CD34+ cell counts to decrease apheresis days and explored the use of a fixed split dose of plerixafor instead of weight-based dosing. We analyzed 235 patients with plasma cell disorders or non-Hodgkin's lymphoma who underwent progenitor cell mobilization and autologous hematopoietic cell transplantation (AHCT) between March 2014 and December 2017. Two hundred ten (89%) received G-CSF plus Plerixafor and 25 (11%) received G-CSF alone. Overall, 180 patients (77%) collected in 1 day, 53 (22%) in 2 days and 2 (1%) in 3 days. Based on our data, we present a probabilistic algorithm to identify patients likely to require more than one day of collection using G-CSF alone. CD34+ cell yield, ANC and platelet recovery were not significantly different between fixed and standard dose plerixafor. Plerixafor enabled collection in 1 day and with estimated savings of $5000, compared to patients who did not receive plerixafor and required collection for three days. While collection and processing costs and patient populations vary among institutions, our results suggest re-evaluation of current algorithms.
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Affiliation(s)
- Srinivasa Reddy Sanikommu
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Emily S Reese
- Department of Translational Science, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Jiaxian He
- Department of Cancer Biostatistics, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Carlos Lee
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Jing Ai
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Candace M Butler
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Ryan Jacobs
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Bei Hu
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Shebli Atrash
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Jigar Trivedi
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Manisha Bhutani
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Peter Voorhees
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Saad Z Usmani
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Nilanjan Ghosh
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Omotayo Fasan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Lawrence J Druhan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - James Symanowski
- Department of Cancer Biostatistics, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Edward A Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
| | - Belinda R Avalos
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina, USA
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Gniadek T. Production of Components by Apheresis. Transfus Med 2021. [DOI: 10.1002/9781119599586.ch6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cid J, Carbassé G, Alba C, Perea D, Lozano M. Leukocytapheresis in nonmobilized donors for cellular therapy protocols: Evaluation of factors affecting collection efficiency of cells. J Clin Apher 2019; 34:672-679. [DOI: 10.1002/jca.21745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/05/2019] [Accepted: 08/12/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Joan Cid
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and HemostasisICMHO, Hospital Clínic, University of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
| | - Gloria Carbassé
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and HemostasisICMHO, Hospital Clínic, University of Barcelona Barcelona Spain
| | - Cristina Alba
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and HemostasisICMHO, Hospital Clínic, University of Barcelona Barcelona Spain
| | - Dolores Perea
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and HemostasisICMHO, Hospital Clínic, University of Barcelona Barcelona Spain
| | - Miquel Lozano
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and HemostasisICMHO, Hospital Clínic, University of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
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Setia RD, Arora S, Handoo A, Dadu T, Choudhary D, Sharma SK, Kharya G, Khandelwal V, Sachdeva P, Doval D, Bakliwal A, Kapoor M, Bajaj S, Bachchas V, Singh P. Comparison of Amicus and COBE Spectra for allogenic peripheral blood stem cell harvest: Study from tertiary care centre in India. Transfus Apher Sci 2017; 56:439-444. [DOI: 10.1016/j.transci.2017.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/07/2017] [Accepted: 04/08/2017] [Indexed: 10/19/2022]
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Production of Components by Apheresis. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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7
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Giralt S, Costa L, Schriber J, Dipersio J, Maziarz R, McCarty J, Shaughnessy P, Snyder E, Bensinger W, Copelan E, Hosing C, Negrin R, Petersen FB, Rondelli D, Soiffer R, Leather H, Pazzalia A, Devine S. Optimizing autologous stem cell mobilization strategies to improve patient outcomes: consensus guidelines and recommendations. Biol Blood Marrow Transplant 2013; 20:295-308. [PMID: 24141007 DOI: 10.1016/j.bbmt.2013.10.013] [Citation(s) in RCA: 257] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 10/10/2013] [Indexed: 12/13/2022]
Abstract
Autologous hematopoietic stem cell transplantation (aHSCT) is a well-established treatment for malignancies such as multiple myeloma (MM) and lymphomas. Various changes in the field over the past decade, including the frequent use of tandem aHSCT in MM, the advent of novel therapies for the treatment of MM and lymphoma, and the addition of new stem cell mobilization techniques, have led to the need to reassess current stem cell mobilization strategies. Mobilization failures with traditional strategies are common and result in delays in treatment and increased cost and resource utilization. Recently, plerixafor-containing strategies have been shown to significantly reduce mobilization failure rates, but the ideal method to maximize stem cell yields and minimize costs associated with collection has not yet been determined. A panel of experts convened to discuss the currently available data on autologous hematopoietic stem cell mobilization and transplantation and to devise guidelines to optimize mobilization strategies. Herein is a summary of their discussion and consensus.
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Affiliation(s)
- Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Luciano Costa
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Jeffrey Schriber
- Cancer Transplant Institute, Virginia G Piper Cancer Center, Scottsdale, Arizona
| | - John Dipersio
- Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | | | - John McCarty
- Adult Bone Marrow Transplant, Virginia Commonwealth University, Richmond, Virginia
| | - Paul Shaughnessy
- Adult Bone Marrow Transplant, Texas Transplant Institute, San Antonio, Texas
| | - Edward Snyder
- Yale University Medical School, New Haven, Connecticut
| | | | - Edward Copelan
- Levine Cancer Institute I, Carolinas HealthCare System, Charlotte, North Carolina
| | | | | | - Finn Bo Petersen
- Intermountain Blood and Marrow Transplant Program, Intermountain Healthcare, Salt Lake City, Utah
| | - Damiano Rondelli
- Section of Hematology/Oncology, University of Illinois at Chicago Cancer Center, Chicago, Illinois
| | - Robert Soiffer
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Amy Pazzalia
- Adult Bone Marrow Transplant, University of Florida, Gainesville, Florida
| | - Steven Devine
- Department of Internal Medicine/Hematology/Oncology, Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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Winters JL, Burgstaler EA, Gottschall JL, Balogun RA, Houghton JR, Lee WJ, Snyder EL. A multicenter evaluation of a new therapeutic plasma exchange procedure. Transfusion 2013; 53:3269-78. [PMID: 23581280 DOI: 10.1111/trf.12189] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 01/23/2013] [Accepted: 02/21/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND The AMICUS (Fenwal, Inc.) was cleared in the United States for platelet (PLT) and plasma collection in 1996 with subsequent clearances for the collection of other blood products. Although not previously used for therapeutic plasma exchange (TPE), new disposables, software, and hardware were developed to enable TPE on the AMICUS. STUDY DESIGN AND METHODS A multicenter, randomized, nonblinded, crossover paired treatment protocol was performed. Thirty patients with orders for at least two TPE procedures were randomly assigned to the AMICUS or the COBE Spectra (TerumoBCT) for the first treatment. Each patient was crossed over to the other device using the same procedure settings from the first procedure. The primary objective compared efficiency of plasma removal (EPR) with secondary objectives of comparing PLT and hemoglobin (Hb) waste plasma content, coagulation factor and complement activation, fluid balance tracking accuracy, procedure length, and adverse events. RESULTS The EPR for the AMICUS (81.9 ± 7.62%) was superior to that of the COBE Spectra (75.2 ± 6.29%; p = 0.00001). The AMICUS also demonstrated statistically higher fluid balance accuracy (99.84%) compared to that of the COBE Spectra (98.83%; p < 0.0001) and a statistically shorter procedure time (103.9 ± 30.8 vs. 110.5 ± 27.1 min, p < 0.001). No significant differences with regard to PLT and Hb content in the waste plasma, change in patient PLT count, or changes in markers of coagulation and complement cascade activation were seen. Frequency and severity of adverse reactions were similar. CONCLUSION The AMICUS separator can effectively perform TPE. The AMICUS demonstrated superior plasma removal efficiency compared to the COBE Spectra with no evidence of significant differences in PLT removal, hemolysis, and coagulation or complement activation.
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Affiliation(s)
- Jeffrey L Winters
- Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota; BloodCenter of Wisconsin, Milwaukee, Wisconsin; Division of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; Hollister, Inc., Libertyville, Illinois; Fenwal, Lake Zurich, Illinois; Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
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Suter SE. Collection of peripheral blood CD34+ progenitor cells from healthy dogs and dogs diagnosed with lymphoproliferative diseases using a Baxter-Fenwal CS-3000 Plus blood cell separator. J Vet Intern Med 2012; 25:1406-13. [PMID: 22092635 DOI: 10.1111/j.1939-1676.2011.00827.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Canine peripheral blood mononuclear cell (PBMC) apheresis using a Baxter-Fenwal CS-3000 Plus automated blood cell separator has not been reported. OBJECTIVE To determine the feasibility and safety of using a CS-3000 Plus blood cell separator with a small volume separation container holder (SVSCH) and small volume collection chamber (SVCC) to harvest canine PBMCs from dogs weighing <50 kg. ANIMALS Eight healthy mongrel dogs and 11 client-owned dogs in clinical remission for lymphoproliferative diseases (LPD). METHODS In this prospective study, aphereses were performed using a Baxter-Fenwal CS-3000 Plus blood cell separator, with or without recombinant human granulocyte colony-stimulating factor (rhG-CSF) treatment. RESULTS Aphereses from 6 healthy dogs given rhG-CSF yielded an average of 1.1 × 10(7) ± 8.2 × 10(6) CD34+ cells/kg. Aphereses from LPD dogs given rhG-CSF yielded an average of 5.4 × 10(6) ± 3.25 × 10(6) CD34+ cells/kg (P = .17). Higher hematocrit in both groups of dogs receiving rhG-CSF correlated with an increased number of CD34+ cells/kg harvested (healthy, P = .04; LPD, P = .05). Apheresis was well tolerated by all dogs. CONCLUSIONS AND CLINICAL IMPORTANCE Canine PBMC apheresis using the Baxter-Fenwal CS-3000 Plus cell separator with an SVSCH and SVCC is a feasible and safe option for harvesting an adequate number of CD34+ peripheral blood progenitor cells from dogs weighing ≥17 kg for hematopoietic cell transplantation.
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Affiliation(s)
- S E Suter
- College of Veterinary Medicine Teaching Hospital, North Carolina State University, Raleigh, NC 27606, USA.
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Production of Components by Apheresis. Transfus Med 2011. [DOI: 10.1002/9781444398748.ch7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Witt V, Beiglböck E, Fritsch G. Bone marrow processing with the AMICUS™ separator system. J Clin Apher 2011; 26:195-9. [DOI: 10.1002/jca.20293] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 05/09/2011] [Indexed: 01/04/2023]
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Burgstaler EA, Winters JL. Comparison of hematopoietic progenitor cell collections using the COBE Spectra version 7 and Amicus version 3.1 for patients with al amyloidosis. J Clin Apher 2011; 26:186-94. [DOI: 10.1002/jca.20292] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 04/25/2011] [Indexed: 11/10/2022]
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Burgstaler EA, Porrata LF, Markovic SN, Winters JL. Use of various offset settings in the Fenwal Amicus during hematopoietic progenitor cell collection to increase lymphocyte yield and reduce cross-cellular contamination. J Clin Apher 2010; 25:301-9. [PMID: 20824623 DOI: 10.1002/jca.20259] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 07/12/2010] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Autologous HPC collection focus has been CD34+ cell yield but product content of other cells is important for patient survival, complications, and resource utilization. METHODS Prospective, paired study examining MNC and RBC offsets (opens and closes collect valve, respectively) was performed using Fenwal Amicus. Lymphocyte, CD34+ cell yields, and cross-cellular contamination were compared using different MNC/RBC offsets and retrospective Spectra data. RESULTS In paired comparisons, median lymphocyte yields were significantly different only between 0.0/7.0 (17.6 × 10(9)) and 1.5/5.0 (14.5 × 10(9)) offsets. CD34+ yields were not significantly different between offsets except 1.0/7.0 and 1.5/5.0 (230.3 vs. 156.7 × 10(6)). Granulocytes, RBC, and PLT were significantly greater with higher RBC offset. Comparing all offsets, 1.5/5.0 collected fewer lymphocytes, granulocytes, RBC, and PLT. 1.5/6.0 offsets collected more lymphocytes than 1.5/5.0 but fewer granulocytes and RBC than others except 1.5/5.0. For 1.5/6.0 offsets, PLT content was higher than 1.5/5.0, equivalent to the other offsets, and less than Spectra. CD34+ yields for 1.5/6.0 offsets were equivalent to others except 1.0/7.0. Manufacturer's default (2.3/6.8) collected equivalent lymphocytes and CD34+ to all offsets (except 1.0/7.0) and Spectra. Cross-cellular contamination was higher than 1.5/5.0 and 1.5/6.0 but equivalent to others with more RBC and fewer PLT than Spectra. CONCLUSION For maximum lymphocyte yield and minimum contamination, 1.5/6.0 offsets appear optimal. For minimum lymphocyte yield and contamination, 1.5/5.0 offsets would be preferred. Manufacturer's default has CD34+ cell and lymphocyte yields similar to 1.5/6.0 with greater contamination. Amicus can achieve lymphocyte and CD34+ yields similar to Spectra but has significantly less PLT removal.
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Affiliation(s)
- Edwin A Burgstaler
- Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
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Ikeda K, Ohto H, Kanno T, Ogata T, Noji H, Ogawa K, Maruyama Y. Automated programs for collection of mononuclear cells and progenitor cells by two separators for peripheral blood progenitor cell transplantation: comparison by a randomized crossover study. Transfusion 2007; 47:1234-40. [PMID: 17581158 DOI: 10.1111/j.1537-2995.2007.01256.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although automated programs have been increasingly used to collect peripheral blood (PB) progenitor cells (PBPCs), differences among them remain unclear. The automated programs of Amicus (Baxter Healthcare) and Spectra (software Version 6.1, Gambro BCT) apheresis machines were compared in a crossover study. STUDY DESIGN AND METHODS The patients for autologous and donors for allogeneic PBPC transplantation mobilized with granulocyte-colony-stimulating factor were randomly assigned into two groups. PBPCs were collected by the Amicus on the first day and the Spectra on the second of 2 consecutive days in Group I, and the reverse order was used in Group II. Of 39 patients or donors enrolled, 17 reached their collection goal with only one procedure and did not participate in the paired study. Thus, 44 paired procedures of the remaining 22 subjects were evaluated. RESULTS The product yields of white blood cells (WBCs; p < 0.005), mononuclear cells (MNCs; p < 0.02), and CD34+ PBPCs (p < 0.0002) from patients or donors were higher in the Amicus collections than those in the Spectra collections. The collection efficiencies of WBCs (p < 0.03), MNCs (p < 0.02), and CD34+ PBPCs (p < 0.03) were higher in the Amicus collections. The numbers of contaminating platelets (PLTs) in the Amicus collections were lower than those in the Spectra collections (p < 0.05) with a greater decrease in PB PLT counts after apheresis with the Spectra (p < 0.01). The Amicus had a longer running time than the Spectra for processing similar volumes (p < 0.005). CONCLUSION The automated program of the Amicus may be better than that of the Spectra for collecting MNCs and CD34+ PBPCs and avoiding apheresis-induced thrombocytopenia.
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Affiliation(s)
- Kazuhiko Ikeda
- Division of Blood Transfusion and Transplantation Immunology, Department of Internal Medicine I, Fukushima Medical University, Fukushima, Japan.
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Movassaghi K, Jaques G, Schmitt-Thomssen A, Fischer EG, Paulus M, Heuft HG, Schwella N. Evaluation of the COM.TEC cell separator in predicting the yield of harvested CD34+ cells. Transfusion 2007; 47:824-31. [PMID: 17465947 DOI: 10.1111/j.1537-2995.2007.01196.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This multicenter study was performed with the intention to evaluate the exactness of the predicted CD34+ cell yield calculated by two leukapheresis programs of the cell separator COM.TEC upon the number of donor's circulating CD34+ cells and the blood volume processed. STUDY DESIGN AND METHODS Patients and healthy donors (n = 166) received mobilization by chemotherapy and/or granulocyte colony-stimulating factor and underwent CD34+ cell harvest by the leukapheresis programs MNC or RV-PBSC (n = 203). RESULTS CD34+ cells were collected by 112 harvests on MNC and by 91 collections on RV-PBSC. The median collection efficiency of CD34+ cells was significantly better for the program MNC than for RV-PBSC (p < 0.001): 67% (31-109) vs. 42% (19-100). The collected CD34+ cell yield was in median more exactly by MNC than by RV-PBSC (p < 0.001): 85% (31-176) vs. 59% (22-110) of the predicted value. Concentrates obtained by RV-PBSC showed in median significantly higher percentages of mononuclear cells (p < 0.001) and CD34+ cells (p < 0.001), 86% (43-99) vs. 56% (25-95) and 1.2% (0.2-14.3) vs. 0.4% (0.1-6.0), and had lower contaminations by erythrocytes (p < 0.001) and platelets (p < 0.001), 13 mL (4-48) vs. 25 mL (5-60) and 1.9 x 1011 vs. 3.1 x 1011, than those harvested by MNC. CONCLUSION The significantly better collection efficiency of CD34+ cells and the more exact prediction of the harvested CD34+ cell yield make the leukapheresis program MNC a safe and efficient procedure. However, concentrates collected by RV-PBSC are of a better cellular quality with a significantly higher percentage of mononuclear and CD34+ cells and a lower contamination by erythrocytes and platelets.
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Affiliation(s)
- Kamran Movassaghi
- Institute of Transfusion Medicine, Charité University Hospital, Humboldt University, Berlin, Germany.
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Altuntas F, Kocyigit I, Ozturk A, Kaynar L, Sari I, Oztekin M, Solmaz M, Eser B, Cetin M, Unal A. Comparison of the Fenwal Amicus and Fresenius Com.Tec cell separators for autologous peripheral blood progenitor cell collection. Transfus Apher Sci 2007; 36:159-67. [PMID: 17369096 DOI: 10.1016/j.transci.2006.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 10/04/2006] [Accepted: 10/10/2006] [Indexed: 02/08/2023]
Abstract
Peripheral blood progenitor cells (PBPC) are commonly used as a stem cell source for autologous transplantation. This study was undertaken to evaluate blood cell separators with respect to separation results and content of the harvest. Forty autologous PBPC collections in patients with hematological malignancies were performed with either the Amicus or the COM.TEC cell separators. The median product volume was lower with the Amicus compared to the COM.TEC (125 mL vs. 300 mL; p < 0.001). There was no statistically significant difference in the median number of CD34+ cell/kg in product between the Amicus and the COM.TEC (3.0 x 10(6) vs. 4.1 x 10(6); p = 0.129). There was a statistically higher mean volume of ACD used in collections on the Amicus compared to the COM.TEC (1040 +/- 241 mL vs. 868 +/- 176 mL; p = 0.019). There was a statistical difference in platelet (PLT) contamination of the products between the Amicus and the COM.TEC (0.3 x 10(11) vs. 1.1 x 10(11); p < 0.001). The median % decrease in PB PLT count was statistically higher in the COM.TEC compared to the Amicus instruments (18.5% vs. 9.5%; p = 0.028). In conclusion, both instruments collected PBPCs efficiently. However, Amicus has the advantage of lower PLT contamination in the product, and less decrease in PB platelet count with lower product volume in autologous setting.
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Affiliation(s)
- Fevzi Altuntas
- Erciyes Medical School, Department of Hematology and Apheresis Unit, Kayseri 38039, Turkey.
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Witt V, Beiglböck E, Ritter R, Würth M, Peters C, Ladenstein R, Gadner H, Fritsch G. Performance of a new separator system for routine autologous hematopoietic progenitor cell collection in small children. J Clin Apher 2007; 22:306-13. [DOI: 10.1002/jca.20152] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Abdelkefi A, Maamar M, Torjman L, Ladeb S, Lakhal A, Ben Othman T, Slama H, Jenhani F, Mojaat N, Ben Hamed L, Bouhoula S, Hsairi M, Boukef K, Ben Abdeladhim A. Prospective randomised comparison of the COBE Spectra version 6 and Haemonetics MCS+ cell separators for hematopoietic progenitor cells leucapheresis in patients with multiple myeloma. J Clin Apher 2006; 21:111-5. [PMID: 16395725 DOI: 10.1002/jca.20074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A randomised crossover trial of two separators was undertaken to compare the mononuclear cell, CD34(+) cell and CFU-GM yield, in patients (<61 years) with previously untreated symptomatic multiple myeloma. After first-line therapy, all patients received mobilising chemotherapy (cyclophosphamide 4 g/m(2)) and daily G-CSF. The first leucapheresis was performed on the first day the peripheral blood absolute CD34(+) cell count was > 20 cells/microl. All patients underwent 2 leucaphereses on consecutive days. The patients were randomised to undergo either the first or second leucapheresis using the COBE Spectra. The target duration of the procedure on the COBE Spectra was 2 total blood volumes, and for the Haemonetics MCS(+) it was 20 cycles with four recirculations. Between September 2003 and March 2005, 60 patients were entered in the study. COBE Spectra version 6 processed significantly larger volumes of blood than the Haemonetics MCS(+) (8,845 and 5,680 ml, respectively, P < 0.01). The absolute yield of mononuclear cells (2.1 vs. 1.5 x 10(8)/kg, P = 0.04), CFU-GM (11 vs. 3 x 10(4)/kg, P = 0.01) and CD34(+) cells (3 vs. 1.7 x 10(6)/kg, P = 0.02) were all significantly higher with the COBE Spectra version 6, as were the yields per unit volume of blood processed. In conclusion, our study shows that COBE Spectra Version 6 is faster and has a better yield than the Haemonetics MCS(+), in patients with multiple myeloma.
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Affiliation(s)
- A Abdelkefi
- Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.
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Ageyama N, Hanazono Y, Shibata H, Ono F, Ogawa H, Nagashima T, Ueda Y, Yoshikawa Y, Hasegawa M, Ozawa K, Terao K. Safe And Efficient Collection of Cytokine-Mobilized Peripheral Blood Cells From Cynomolgus Monkeys (Macaca fascicularis) with Human Newborn-Equivalent Body Weights. Exp Anim 2005; 54:421-8. [PMID: 16365519 DOI: 10.1538/expanim.54.421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Hematopoietic stem cells in bone marrow can be mobilized into peripheral blood by cytokine administration. Cytokine-mobilized peripheral blood stem cells are of great use in clinical applications. We previously established a modified procedure for the collection of cytokine-mobilized peripheral blood cells from rhesus monkeys (Macaca mulata) using a commercially available apparatus originally developed for human subjects. In this study, we examined the efficacy and safety of this method with even smaller macaques, cynomolgus monkeys (Macaca fascicularis), which are equivalent to human newborns in body weight (mean = 3.3 kg). Using the manufacturer's unmodified protocol (n=6), one monkey died of cardiac failure and three developed severe anemia. In contrast, using our modified procedure (n=6), no such complication was observed in any animal. In addition, the harvested nuclear cell, mononuclear cell and CD34(+) cell counts were significantly higher with the modified method. The modified method should allow safe and efficient collection of cytokine-mobilized peripheral blood cells from non-human primates as small as human newborns in a non-invasive manner.
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Affiliation(s)
- Naohide Ageyama
- Tsukuba Primate Research Center, National Institute of Biomedical Innovation, Ibaraki, Japan
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20
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Moog R. Apheresis techniques for collection of peripheral blood progenitor cells. Transfus Apher Sci 2004; 31:207-20. [PMID: 15556469 DOI: 10.1016/j.transci.2004.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2004] [Accepted: 07/01/2004] [Indexed: 11/19/2022]
Abstract
The combination of effective mobilisation protocols and efficient use of apheresis machines has caused peripheral blood progenitor cells (PBPC) transplantation to grow rapidly. The development of apheresis technology has improved over the years. Today PBSC procedures have changed towards systems to minimise operator interaction and to reduce the collection of undesired cells such as polymorphonuclear cells and platelets using functionally closed, sterile environments for PBSC collection in keeping with Good Manufacturing Practice guidelines. Blood cell separators with continuous flow technique allow the processing of more blood than intermittent flow devices resulting in higher PBSC yields. Large volume leukapheresis with the processing of 3-4-fold donor's/patient's blood volume can increase the number of collected progenitor cells. Therefore, intermittent flow cell separators are indicated if only single vein access is available. Anticoagulant induced hypocalcaemia is an often observed side effect in long lasting PBPC harvesting and monitoring of electrolytes should be performed especially at the end of the apheresis procedure to supplement low levels of potassium, calcium or magnesium. Refinement and improvement of collection techniques continue to add to the armamentarium of current approaches for cancer and non-malignant conditions and will enable future strategies.
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Affiliation(s)
- Rainer Moog
- Institute for Transfusion Medicine, University Clinics Essen, Hufelandstrasse 55, Essen 45122, Germany.
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Moog R. Comparison of Two Continuous-Flow Systems for the Collection of Peripheral Progenitor Cells. Stem Cells Dev 2004; 13:357-61. [PMID: 15345129 DOI: 10.1089/scd.2004.13.357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
New advances in apheresis technology allow for the safe and efficient collection of peripheral progenitor cells (PPC). Two blood cell separators were compared with respect to separation results such as PPC yield and contamination of the products. A total of 11 patients (6 multiple myeloma, 4 non-Hodgkin lymphoma, and 1 medulloblastoma) underwent PPC collections with either the Amicus (Baxter) or AS. TEC (Fresenius) blood cell separator. PPC were mobilized by chemotherapy and granulocyte colony-stimulating factor (G-CSF) application. Blood counts were determined before and after apheresis as well as in the PPC product. CD34 antigen-expressing cells were measured in the peripheral blood and in the PPC product by flow cytometry. Median baseline CD34 antigen-expressing cells were higher in patients undergoing PPC collection with the Amicus device. More PPC/kg of body weight were collected with this machine (5.3 x 10(6)/kg body weight versus 1.7 x 10(6) in the AS. TEC). The median volume was 129 ml (range 80-156 ml) for Amicus products and 111 ml (range 66-202 ml) for the AS. TEC, respectively. The median platelet contamination of the products from the Amicus blood cell separator was significantly lower than in products from the AS. TEC machine (0.17 x 10(11) versus 0.65 x 10(11), p < 0.001). The data show that a higher yield of PPC was collected with the Amicus machine. The platelet contamination of the products obtained from the two blood cells separators was significantly different.
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Affiliation(s)
- R Moog
- Institute for Transfusion Medicine, University Clinics Essen, D-45122 Essen, Germany.
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22
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Hartwig D, Dorn I, Kirchner H, Schlenke P. Recommendations for optimized settings of the Amicus Crescendo cell separator for the collection of CD34+ progenitor cells. Transfusion 2004; 44:758-63. [PMID: 15104659 DOI: 10.1111/j.1537-2995.2004.03411.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND CD34+ PBPCs for autologous transplantation purposes are collected by leukapheresis procedures on automated cell separators. In this study, the influence of different parameters on collection efficiency (CE) of the Amicus Crescendo cell separator (Baxter) was investigated. STUDY DESIGN AND METHODS A total of 146 PBPC collections with Amicus cell separators were performed in 56 patients with either settings recommended by the manufacturer or modified settings to identify variables that have a significant and important impact on CE. RESULTS By use of a standard setting with a cycle volume of 1400 mL, CE significantly decreases when patients' preapheresis peripheral blood WBC counts are between 25,000 and 35,000 per micro L. CE can be improved if cycle volume is reduced to 1000 mL. If WBC concentrations exceed 55,000 per micro L before apheresis, CE also significantly decreases despite of reduced cycle volume. Additionally, high flow rates greater than 60 mL per minute significantly reduce CE. CONCLUSION Parameters influencing the outcome of CD34+ PBPC collections were identified, such as patients' WBC count, cycle volume, and whole blood flow rate. An optimized adjustment of these variables will further increase the CE of the device.
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Affiliation(s)
- Dirk Hartwig
- Institute of Immunology and Transfusion Medicine, Luebeck, Germany.
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23
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Moog R, Basu O, Kremens B. Collection of peripheral progenitor cells in paediatric patients with a new programme for the collection of mononuclear cells. J Clin Apher 2003; 18:111-4. [PMID: 14569600 DOI: 10.1002/jca.10050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
When harvesting peripheral progenitor cells (PPC) in children, the special situation of their circulatory system has to be taken into account. Therefore, extracorporeal blood volume and product volume should be small to avoid side effects. Nine children (age 2-14 years, weight 12.8-58.5 kg) with malignancies underwent 10 PPC collections with the MNC programme of the Amicus blood cell separator. The disposable kit was primed with red blood cells (RBCs) or human albumin to avoid circulatory side effects. The children were monitored for blood pressure and heart rate during the whole apheresis procedure. A median blood volume of 4,577 ml (range 3,536-8,596 ml) was processed in a separation time of 270 min (range 176-331 min). The median product weight was 81 g (range 53-107 g) and the yield of CD 34 antigen expressing cells was 12.5 x 10(6)/kg body weight (range 1.8-26 x 10(6)/kg body weight). Only one child had to undergo a second apheresis to collect the desired transplantation dose. The median platelet contamination of the product was 0.32 x 10(11) (0.13-0.85 x 10(11)). No circulatory side effects were observed. Blood flow alarms occurred in seven of ten aphereses and one collection had to be terminated due to insufficient flow. PPC can be efficiently collected in children with the MNC programme without circulatory side effects. The platelet contamination of the product was low due to the elutriation principle of the collection process, thereby avoiding thrombocytopenic bleeding episodes in the patients.
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Affiliation(s)
- R Moog
- Institute for Transfusion Medicine, University Clinics Essen, Essen, Germany.
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24
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Jeanne M, Bouzgarrou R, Lafarge X, Fizet D, Dazey B, Vezon G, Ivanovic Z. Comparison of CD34+ cell collection on the CS-3000+ and Amicus blood cell separators. Transfusion 2003; 43:1423-7. [PMID: 14507274 DOI: 10.1046/j.1537-2995.2003.00516.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mobilized PBPCs, detectable on the basis of CD34 expression, can be collected on various cell separators. The CD34+ cell collection efficiencies of two cell separators (CS-3000+ and Amicus, Baxter) were tested on two comparable groups of oncology patients. STUDY DESIGN AND METHODS Leukapheresis assisted by the standard manufacturer's software and variables settings was performed in 37 (CS-3000+) and 34 (Amicus) patients (total of 83 and 67 collections, respectively) after chemotherapy plus G-CSF treatment. RESULTS The total CD34+ cell count per leukapheresis components as well as per kg of patient's body weight were twofold higher by using the Amicus than the CS-3000+ device. Platelet contamination in Amicus components was twice as low compared to the CS3000+. Mean Amicus CD34+ collection efficiency (CD34+eff) (54.9 +/- 27.2%) was significantly higher (p < 0.015) than the CS-3000+ (46.4 +/- 16.7%) one. However, Amicus CD34+eff decreased progressively as the peripheral blood CD34+ concentrations increases over 200 CD34+ cells per microL. A parallel increase in the WBC counts in these cases seems to be the principal cause of decrease in CD34+eff (evident for WBCs >40 x 10(3)/microL and most pronounced for WBCs >60 x 10(3)/microL). CONCLUSIONS Mean CD34+eff and CD34+ cell yields were better on Amicus than on CS-3000+. CD34+eff of Amicus, however, seems to be related to the initial WBC counts, decreasing progressively when WBC increased over 4 x 10(3) per microL that coincided with the increase in CD34+ cell concentrations. For these cases, the volume and duration of cycles should be adapted to optimize CD34+ collections by using Amicus separators.
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Affiliation(s)
- Michel Jeanne
- French Blood Establishment-Aquitaine-Limousin, Bordeaux, France
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25
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Perseghin P, Dassi M, Balduzzi A, Rovelli A, Bonanomi S, Uderzo C. Mononuclear cell collection in patients undergoing extra-corporeal photo-chemotherapy for acute and chronic graft-vs.-host-disease (GvHD): comparison between COBE Spectra version 4.7 and 6.0 (AutoPBSC). J Clin Apher 2003; 17:65-71. [PMID: 12210708 DOI: 10.1002/jca.10021] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A constant improvement in the performance of blood cell separators has been observed in recent years, allowing better yields in peripheral blood stem cell collection (PBSC) either from healthy donors or for autologous purposes. Nevertheless, to our knowledge, no reports on the efficiency of mononuclear cell (MNC) collection in patients undergoing extra-corporeal photochemotherapy (ECP) for graft-vs.-host-disease (GvHD) have been published. We retrospectively investigated the efficiency of 167 MNC collections performed consecutively in 12 patients between January 1999 and June 2001 by means of the COBE Spectra version 4.7 (V 4.7) or version 6.0 (V 6.0), for 109 and 58 procedures, respectively. MNC fractional extraction (FE) was higher in the V 6.0 group compared to the V 4.7 group : 0.59 +/- 0.21 vs. 0.51 +/- 0.22 (P < 0.05). However, platelet contamination was lower in the products obtained with V.6.0 compared to those obtained with V.4.7: 740 ( 630 x 10(3)/(L vs. 2,073 ( 1,429 x 10(3)/(L (P < 0.05). Only two patients with acute GvHD, both from V 4.7 group, required post-ECP platelet transfusion. The recently released version 6.0 allowed a satisfactory MNC yield with minimal platelet contamination in patients scheduled to undergo ECP for acute or chronic GvHD.
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Affiliation(s)
- Paolo Perseghin
- Servizio di Immunoematologia e Trasfusionale, Unità di Aferesi e Criobiologia, Università di Milano-Bicocca, Ospedale San Gerardo de' Tintori, Monza, Italy.
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26
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Ikeda K, Ohto H, Nemoto K, Yamamoto G, Kato K, Ogata T, Shichishima T, Maruyama Y. Collection of MNCs and progenitor cells by two separators for PBPC transplantation: a randomized crossover trial. Transfusion 2003; 43:814-9. [PMID: 12757534 DOI: 10.1046/j.1537-2995.2003.00422.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Efficient collection of progenitor cells is essential for PBPC transplantation. Two apheresis machines (Amicus, Baxter Healthcare; and Spectra, Gambro BCT, software version 4.7) were compared prospectively by a crossover trial. STUDY DESIGN AND METHODS Apheresis collections were performed for two consecutive days on patients for autologous and donors for allogeneic PBPC transplantation. The patients and donors, receiving a G-CSF, were randomized into two groups. In Group I, PBPCs were collected by the Amicus on the 1st day and the Spectra on the 2nd day, and the reverse order was used with Group II. A total of 60 apheresis procedures of 30 (16 in Group I and 14 in Group II) among 40 patients and donors enrolled were performed and evaluated. RESULTS The nucleated cell counts, MNC counts, CD34+ PBPC counts, and amounts of CFU-GM collected per procedure were similar with the Amicus and the Spectra. On the other hand, the decrease of peripheral blood platelet counts of patients and donors was more prominent from using Spectra than Amicus (p < 0.0001). Components collected by the Amicus had fewer platelets than those collected by the Spectra (p < 0.0001). The efficiencies of collecting nucleated cells, MNCs, and CD34+ PBPCs were not different between the machines (p > 0.05). However, the efficiency of collecting platelets was significantly higher with Spectra than with Amicus (p < 0.0001). The Amicus took longer than the Spectra to process the same volume (p < 0.05). CONCLUSION Amicus is superior to Spectra in avoiding apheresis-induced thrombocytopenia caused by platelets contaminating the collected samples. Therefore, the Amicus is useful for patients with thrombocytopenia or with a less-than-normal platelet count.
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Affiliation(s)
- Kazuhiko Ikeda
- Division of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukishima, Japan
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27
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Schwella N, Braun A, Ahrens N, Rick O, Salama A. Leukapheresis after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation: a novel approach to harvest a second autograft. Transfusion 2003; 43:259-64. [PMID: 12559023 DOI: 10.1046/j.1537-2995.2003.00306.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Autologous peripheral blood progenitor cells (PBPCs) are usually collected after the administration of conventional-dose chemotherapy (CDCT) and growth factors. However, there are no data available concerning the collection of PBPCs after high-dose chemotherapy (HDCT) and autologous hematopoietic transplantation in a larger series. STUDY DESIGN AND METHODS Patients (n = 30) underwent leukapheresis for PBPC harvest after CDCT. After HDCT and autografting, the collection of a second PBPC autograft was attempted. RESULTS Leukapheresis was performed after CDCT in all cases at a median of 118 CD34+ cells per microL (range, 18-589) and resulted in 6.4 x 10(6) CD34+ cells per kg (range, 1.7-29.0). After HDCT and autografting, 24 patients (80%) underwent secondary leukapheresis, although they had a significantly lower median of peripheral blood (PB) CD34+ cells (30/microL; range, 10-171; p < 0.001). In these patients a median of 3.6 x 10(6) CD34+ cells per kg (range, 1.6-10.1) was collected in the post-transplantation course. In the remaining six patients (20%) with PB CD34+ cells < 10 per microL, no PBPC harvesting was performed. These so-called poor mobilizers had received significantly less CD34+ cells for autologous transplantation than patients with successful post-HDCT mobilization (median, 2.5 x 10(6)/kg [range, 1.7-3.0] vs. 6.5 x 10(6)/kg [range, 3.2-19.6]; p < 0.001). CONCLUSION Collection of PBPCs is possible in most patients during the recovery phase of hematopoiesis after HDCT plus autografting, and the number of circulating PBPCs may be related to the CD34+ cell dose transfused by the preceding autograft.
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Affiliation(s)
- Nimrod Schwella
- Division of Hematology/Oncology, Department of Internal Medicine, Philipps University Hospital, Marburg, Germany.
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28
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Schwella N, Movassaghi K, Scheding S, Ahrens N, Salama A. Comparison of two leukapheresis programs for computerized collection of blood progenitor cells on a new cell separator. Transfusion 2003; 43:58-64. [PMID: 12519431 DOI: 10.1046/j.1537-2995.2003.00276.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Peripheral blood progenitor cells (PBPCs) can be collected on various cell separators. Two leukapheresis programs (LP-MNC and LP-PBSC-Lym) were evaluated for computerized collection of PBPCs on a new cell separator. STUDY DESIGN AND METHODS Leukapheresis assisted by the LP-MNC or LP-PBSC-Lym software was performed for the harvesting of PBPCs in 52 oncology patients after chemotherapy plus G-CSF treatment and in 18 healthy subjects after G-CSF mobilization alone. RESULTS A total of 38 components from 33 donors via LP-MNC and 43 components from 37 donors via LP-PBSC-Lym were collected with a median of one (range, one to two) standard-volume leukapheresis procedures (9.2-13.3 L) per donor. There were no significant differences between the two groups concerning median counts of WBCs, CD34+ cells, CD34+ cell yields per harvest, and CD34+ cell yields of cumulative harvests. The blood cell counts after leukapheresis revealed that the LP-MNC resulted in significantly higher platelet loss than LP-PBSC-Lym (p = 0.024): 35.9 percent (range, 19.2%-66.1%) versus 29.7 percent (11.6%-52.3%). Regarding the CD34+ cell collection efficiency, the LP-MNC program was significantly better than the LP-PBSC-Lym program (p < 0.001): 77.5 percent (range, 35.5%-98.9%) versus 58.3 percent (range, 20.4%-98.9%). However, concentrates collected by the LP-PBSC-Lym program had significantly higher percentages of MNCs (p < 0.001) and CD34+ cells (p = 0.028) than harvests with the LP-MNC program: 90 percent (range, 69%-99%) versus 70 percent (range, 35%-98%) and 1.2 percent (range, 0.2%-7.3%) versus 0.7 percent (range, 0.2%-6.0%), respectively. No leukapheresis-related serious adverse events were seen, and time for hematopoietic engraftment was equivalent to data published in the literature. CONCLUSION The LP-MNC program shows a significantly better CD34+ cell collection efficiency than the LP-PBSC-Lym program. However, collections with the LP-MNC program result in PBPC components with a lower MNC and CD34+ cell concentrations and a higher apheresis-related loss of patient's platelets.
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Affiliation(s)
- N Schwella
- Division of Hematology/Oncology, Department of Internal Medicine, Phipps Marburg University Hospital, Germany.
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29
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Moog R. Harvesting of CD34 antigen-expressing cells with a new programme for the collection of mononuclear cells with use of the Amicus (Baxter) blood cell separator. Transfus Med 2002; 12:367-72. [PMID: 12473153 DOI: 10.1046/j.1365-3148.2002.00405.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A study was performed to evaluate a new programme for peripheral blood stem cell (PBSC) collection with the use of the Amicus (Baxter) blood cell separator. Healthy donors (n = 9) and oncology patients (n = 21) scheduled for PBSC transplant were studied. Ten PBSC harvests were performed in the donors and 30 in the patients. A median of 6.37 x 106 CD34+ cells per kg recipient body weight (range 3.08-11.06 x 106) were collected from the donors in a product weight of 169.5 g (118-186). From the patients, 6.26 x 106 CD34+ cells per kg body weight (range 0.2-53.6 x 106) were harvested in a product weighing 121.5 g (range 92-190). The median platelet contamination was 0.93 x 1011 (range 0.45-1.23 x 1011) per donor product and 0.2 x 1011 (range 0.05-0.86 x 1011) per patient product. No severe side effects were observed during or after the PBSC collection procedures.
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Affiliation(s)
- R Moog
- Institut für Transfusionsmedizin, Universitätsklinikum Essen, Essen, Germany.
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30
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Mehta J, Singhal S, Gordon L, Tallman M, Williams S, Luyun R, Ali MY, Oyama Y, Villa M, Shook T, Winter J. Cobe Spectra is superior to Fenwal CS 3000 Plus for collection of hematopoietic stem cells. Bone Marrow Transplant 2002; 29:563-7. [PMID: 11979304 DOI: 10.1038/sj.bmt.1703520] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2001] [Accepted: 02/04/2002] [Indexed: 11/09/2022]
Abstract
One hundred and seventy-seven stem cell apheresis procedures performed on 91 patients using the Fenwal CS 3000 Plus cell separator and 61 procedures performed on 37 patients using the Cobe Spectra cell separator were studied to compare the CD34(+) cell collection efficiencies (CE; the proportion of the total CD34(+) cell content in the blood volumes processed that is harvested) of the two machines. The absolute peripheral blood CD34(+) cell count was comparable for the two groups (P = 0.27). A strong correlation was seen between the blood CD34(+) cell count and the total number of CD34(+) cells collected for the Spectra (r(2) = 0.59; P < 10(-6)) and for the CS 3000 Plus (r(2) = 0.60; P < 10(-6)). No significant correlation emerged between the peripheral blood CD34(+) cell count and the CE of either machine. The total number of CD34(+) cells collected per procedure was comparable (P = 0.51): median 113 x 10(6) for CS 3000 Plus and median 218 x 10(6)for Spectra. CE was significantly higher with the Spectra (median 45.7%, range 9.8-98.6%) than the CS 3000 Plus (median 30.3%, range 1.7-89.3%; P < 0.00001). We conclude that the CD34(+) cell CE of the Spectra is superior to that of the CS 3000 Plus. Therefore, under the usual clinical conditions, Cobe Spectra should be used preferentially for peripheral blood progentor cell collection to maximize the number of hematopoietic stem cells collected.
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Affiliation(s)
- J Mehta
- The Hematopoietic Stem Cell Transplant Program, Division of Hematology/Oncology, Department of Internal Medicine, Northwestern University Medical School, Chicago, IL 60611, USA
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31
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Moog R. Adverse events in peripheral progenitor cell collection: a 7-year experience. JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH 2001; 10:675-80. [PMID: 11672514 DOI: 10.1089/152581601753193896] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Collection of peripheral progenitor cells (PPC) by apheresis machines is generally regarded as a safe procedure. However, data about adverse events in PPC harvesting are scarce. In a monocentric retrospective study, the data of 540 PPC collections in a period of 7 years were reviewed. Adverse events were subdivided in collection-associated technical problems and patient/donor-related side effects. Patient/donor-related side effects occurred most often (19.8%); most of them were paresthesias due to citrate toxicity. Paresthesias were treated by oral (20.4%) or intravenous (1.1%) calcium supplementation. Problems with venous access were also seen frequently, resulting in blood flow alarms (11.3%) and blockades in the return line (4.3%). A total of 6.9% of these problems were catheter associated, requiring revision of the central venous line in 2.6%. Technical problems with the blood cell separators were observed in 11.7%. Ten PPC collections were discontinued due to adverse events. The data of this retrospective, monocentric analysis show that patient/donor-associated problems were observed in every fifth PPC harvest. Most of them were paresthesias, which could be easily treated by calcium supplementation. Problems with venous access and technical problems with the cell separators occurred in every tenth PPC collection.
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Affiliation(s)
- R Moog
- Institute for Transfusion Medicine, University Clinics Essen, Germany.
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32
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Heuft HG, Dubiel M, Rick O, Kingreen D, Serke S, Schwella N. Inverse relationship between patient peripheral blood CD34+ cell counts and collection efficiency for CD34+ cells in two automated leukapheresis systems. Transfusion 2001; 41:1008-13. [PMID: 11493732 DOI: 10.1046/j.1537-2995.2001.41081008.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The purpose of this study was to analyze the CD34 cell collection efficiency (CE) of automated leukapheresis protocols of two blood cell separators (Spectra, COBE [AutoPBSC protocol] and AS104, Fresenius [PBSC-Lym, protocol]) for peripheral blood progenitor cell (PBPC) harvest in patients with malignant diseases. STUDY DESIGN AND METHODS PBPCs were collected by the Spectra AutoPBSC protocol in 95 patients (123 collections) and the AS104 PBSC-Lym protocol in 87 patients (115 harvests). Patients underwent a median of one (range, 1-4) conventional-volume apheresis procedure of 10.8 L (9.0-13.9) to obtain a target cell dose of > or =2.5 x 10(6) CD34+ cells per kg. RESULTS The median overall CD34 CE was significantly better on the AS104 than on the Spectra: 55.8 percent versus 42.4 percent (p = 0.000). This was also true below (59.2% vs. 50.1%; p = 0.022) and above (51.2% vs. 41.3%; p = 0.001) the preleukapheresis threshold of 40 CD34+ cells per microL needed to collect a single-apheresis autograft. However, at > or =40 circulating CD34+ cells per microL, both cell separators achieved the target of > or =2.5 x 10(6) CD34+ cells per kg. The CD34 CE dropped significantly, from 59.2 percent at <40 cells per microL to 51.2 percent at > or =40 cells per microL on the AS104 (p = 0.017) and from 50.1 percent to 41.3 percent on the Spectra (p = 0.033). CONCLUSION Whereas the CD34 CE was significantly different with the AS104 and the Spectra, the CD34 CE of both machines correlated inversely with peripheral blood CD34+ cell counts, showing a significant decline with increasing numbers of circulating CD34+ cells. Nevertheless, at > or 40 preapheresis CD34+ cells per microL, sufficient hematopoietic autografts of > or =2.5 x 10(6) CD34+ cells per kg were harvested by a single conventional-volume (11 L) leukapheresis on both cell separators.
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Affiliation(s)
- H G Heuft
- Blood Bank and Division of Hematology/Oncology, Department of Internal Medicine, Charité University Hospital/Virchow Clinic, Humboldt University, Berlin, Germany.
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Snyder EL, O'Donnell L, Dengler TJ, Pomper GJ, Velleca MA, Dincecco DM, Baril LL, Min K, Gudino MD, Bender JR. Ex vivo evaluation of PBMNCs collected with a new cell separator. Transfusion 2001; 41:940-9. [PMID: 11452164 DOI: 10.1046/j.1537-2995.2001.41070940.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study reports on an evaluation of the ability of a cell separator (Amicus, Baxter Healthcare) and the integral MNC computer software program to collect a variety of MNC subsets. The collection efficiency (CE) of the Amicus for these MNC subsets was compared to that of another cell separator (CS-3000 Plus, Baxter). The collected MNCs were also assayed ex vivo to determine if these cells remained functional. STUDY DESIGN AND METHODS Healthy volunteer blood donors were recruited to provide PBMNCs for the isolation of CD3+, CD4+, CD8+, CD19+, NK, and gammadelta+ cells and monocytes. Cells were collected with an Amicus (test arm; n = 16) or a CS-3000 Plus (control arm; n = 11) cell separator. Cells were counted on a flow cytometer and CEs were calculated. For functional studies, the Amicus-collected MNC data were compared to CS-3000 Plus historical data. Functional studies performed included surface antigen expression assays (CD8+), proliferation assays (CD4+ and CD8+ cells), NK cytotoxicity assays for K562 and HUVE cells, and E-selectin induction on endothelial cells through NK+ contact dependency. Dendritic cells (DCs) were generated from CD34+ cells collected on the Amicus, positively selected by the use of antibody-bound, magnetic bead technology, and then cultured ex vivo with a combination of growth factors to generate the DCs. RESULTS CEs were higher on the Amicus than on the CS-3000 Plus for CD3+ (68 vs. 54%), CD4+ (70 vs. 56%), CD8+ (68 vs. 52%), and CD19+ (60 vs. 48%) cells (p<0.05). For the two separators, CEs were equivalent for monocytes, NK+, and gammadelta+ cells. The Amicus separator collected significantly fewer platelets than did the CS-3000 Plus (p<0.00001). CD4+, CD8+, and NK cells proliferated normally. NK cells appropriately stimulated E-selectin expression on endothelial cells. Culture-generated DCs obtained by using Amicus-collected CD34+ cells expressed appropriate cell surface markers. CONCLUSION The Amicus separator is acceptable for the collection of PBMNC subsets. The device collects CD3+, CD4+, CD8+, and CD19+ T- and B-cell subsets with greater efficiency and collects MNCs with significantly fewer contaminating platelets than does the CS-3000 Plus. Cells collected on the Amicus are suitable for use in a variety of research and clinical immunobiologic studies.
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Affiliation(s)
- E L Snyder
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut 06504, USA.
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