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Chung Y, Kong JH, Hu Y, Lee SN, Shim H, Eom HS, Kong SY. Comparison of spectra optia and amicus cell separators for autologous peripheral blood stem cell collection. J Clin Apher 2020; 36:28-33. [PMID: 32882095 DOI: 10.1002/jca.21835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Autologous peripheral blood stem cell (PBSC) transplantation has become a standard treatment option for many oncology patients. The aim of this study was to evaluate the performance of two cell separators, Spectra Optia (Terumo BCT, Japan) and Amicus (Fresenius-Kabi) for autologous PBSC collection. METHODS We retrospectively evaluated 56 apheresis by Spectra Optia with Continuous Mononuclear Cell Collection (cMNC) from 20 patients, and 50 apheresis by Amicus from 27 patients between December 2018 and December 2019. CD34+ collection efficiency (CE2) and platelet (PLT) loss were evaluated. RESULTS There was no significant difference in CD34+ CE2 between Spectra Optia with cMNC (median, 28.8%) and Amicus (median, 33.1%; P = 0.537). PLT loss was significantly lower in Amicus (median, 28.6%) than in Spectra Optia with cMNC (median, 37.8%; P = 0.009). CONCLUSION CD34+ CE2 was comparable between Spectra Optia and Amicus, and PLT loss was significantly lower in Amicus. To the best of our knowledge, this is the first report comparing autologous PBSC collection of the Spectra Optia and Amicus. These results may provide general guidance with regard to device selection to apheresis clinics that use both separators for optimal outcomes depending on each patient's characteristics.
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Affiliation(s)
- Yousun Chung
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Jung Hee Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Youmi Hu
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Se-Na Lee
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Hyoeun Shim
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Hyeon-Seok Eom
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | - Sun-Young Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
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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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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, 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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Optimization of leukocyte collection and monocyte isolation for dendritic cell culture. Transfus Med Rev 2010; 24:130-9. [PMID: 20303036 DOI: 10.1016/j.tmrv.2009.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Leukapheresis is the method of choice to collect monocytes for dendritic cell (DC) culture. Improvement of cell separators and cell collection software have enabled the collection of 10(9) monocytes for the generation of monocyte-derived DCs, which is sufficient to prepare a DC vaccine series. However, leukapheresis works with the technique of differential centrifugation which is not applicable to selectively collect mononuclear cells of similar density. After leukapheresis, thus, additional preparation steps are required to isolate and enrich the desired monocyte population. The cell isolation and cultivation techniques depend on the quality of the original leukocyte harvest due to the monocyte yield and the content of residual erythrocytes and platelets. Monocyte elutriation from the leukapheresis product shows a high monocyte recovery of 80%. However, only 30% of the isolated monocytes can be developed into mature DCs. The factors responsible for DC maturation and the development of different DC subsets are the subject of current research.
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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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Wolf CE, Meyer M, Riggert J. Leukapheresis for the extraction of monocytes and various lymphocyte subpopulations from peripheral blood: product quality and prediction of the yield using different harvest procedures. Vox Sang 2005; 88:249-55. [PMID: 15877646 DOI: 10.1111/j.1423-0410.2005.00562.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Leukapheresis of non-mobilized healthy donors is performed to harvest monocytes and lymphocyte subpopulations for use in various therapeutic regimens. In this methodological study, we compared two different leukapheresis programs, using equivalent volumes of processed blood over similar processing periods, to determine the influence of the procedures on the donor peripheral blood count and to establish the procedure that yields the highest quality product. MATERIALS AND METHODS The target variables obtained in 41 healthy blood donors who underwent short-term leukapheresis (80-105 min) were retrospectively compared. Twenty-one volunteers were processed on a COBE Spectra machine at the MNC setting and 20 volunteers were processed at the AutoPBSC setting. Data were collected on pre- and postleukapheresis samples and on the product. RESULTS AutoPBSC and MNC procedures resulted in a decrease of haemoglobin (5-7%), platelets (17-20%), monocytes (22%) and lymphocytes (23-27%), but not of granulocytes in peripheral blood. Both procedures produced nearly identical leucocyte and lymphocyte yields. AutoPBSC products contained a greater number of granulocytes, monocytes and red cells, but fewer platelets. The preleukapheresis values correlated with the yields for monocytes, T-helper and T-suppressor cells, B-lymphocytes and natural killer cells, but not for granulocytes or platelets. CONCLUSIONS Leukapheresis is a safe and efficient procedure for collecting large numbers of peripheral blood monocytes and different lymphocyte populations from non-mobilized donors. The two programs yield comparable leucocyte harvests. Based on our results, yields can be predicted from the peripheral cell counts.
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Affiliation(s)
- C E Wolf
- Department of Transfusion Medicine, University of Goettingen, 37075 Goettingen, Germany.
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Strasser EF, Dittrich S, Weisbach V, Zimmermann R, Ringwald J, Achenbach S, Zingsem J, Eckstein R. Comparison of two mononuclear cell program settings on two apheresis devices intended to collect high yields of CD14+ and CD3+ cells. Transfusion 2004; 44:1104-11. [PMID: 15225254 DOI: 10.1111/j.1537-2995.2004.03406.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: 12/01/2022]
Abstract
BACKGROUND In cancer and transplantation therapy apheresis devices and software of optimum standards are required for the collection of high cell yields with high purity of the desired cell fraction. STUDY DESIGN AND METHODS In a paired study, 15 healthy blood donors underwent four 10-L leukapheresis procedures (197 +/- 33 min) with an inlet blood flow rate of 60 mL per minute by use of two different MNC program settings of the COBE Spectra (Gambro BCT) and the AS.TEC 204 (Fresenius Hemocare) cell separators. RESULTS Use of the standard MNC program of both apheresis devices resulted in significantly higher (p < 0.01) collection efficiencies of CD14+ monocytes, CD3+ cells, CD4+ cells, CD8+ T cells, CD16+ CD56+ natural killer (NK) cells, and residual PLTs (p < 0.001), owing to higher centrifuge speed. The mean MNC purity of all components was more than 90 percent. By use of standard programs of either device, significant correlations (p < 0.01) between donor monocytes and preleukapheresis NK cell counts and the corresponding component cell yields were found. CONCLUSION Compared to the program modifications with lower centrifuge velocities the standard MNC programs were significantly more efficient regarding CD14+, CD3+, and CD16+ CD56+ cells. Enhanced centrifuge speed and inlet blood flow rate in MNC programs resulted in higher, similar composed MNC concentrations of the products.
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Affiliation(s)
- Erwin F Strasser
- Department of Transfusion Medicine and Haemostaseology, University Hospital, FAU Erlangen-Nürnberg, Germany
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Adorno G, Del Proposto G, Palombi F, Bruno A, Ballatore G, Postorino M, Tendas A, Del Poeta G, Isacchi G, Amadori S. Collection of peripheral progenitor cells: a comparison between Amicus and Cobe-Spectra blood cell separators. Transfus Apher Sci 2004; 30:131-6. [PMID: 15062751 DOI: 10.1016/j.transci.2003.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2003] [Revised: 10/01/2003] [Accepted: 10/28/2003] [Indexed: 11/17/2022]
Abstract
The authors compared the efficiency of two different blood cell separators (Amicus and Cobe-Spectra) in collecting peripheral blood progenitor cells for autologous or homologous transplantation. A total number of 129 procedures were performed, 36 with Spectra, 93 with Amicus. There was no difference between Spectra and Amicus efficiencies for CD34+ cell collection (46.685% vs 46.235%; p=n.s) but the platelet efficiencies were 17.31% and 12.54% respectively (p=0.04) and, if autologous and allogeneic collections were considered separately, a marked difference resulted in allogeneic platelet efficiency between 6 Spectra and 23 Amicus procedures (26.83% vs 8.68%, p=0.0004). The authors were able to demonstrate that in 70 Amicus autologous collections there was a different platelet efficiency, if peripheral count was considered: 12 procedures performed with a platelet count > 100 x 10(9)/l had a very low efficiency (6.86%), but this value increased if platelet count lowered (13.02% if between 100 and 50 x 10(9)/l, 22.63% if between 50 and 0 x 10(9)/l, 23 and 35 procedures respectively). The study is preliminary and the number of collections is little, but the overall data suggest that Spectra (AutoPBSC, V 6.0) and Amicus separators have the same efficiency for collecting CD34+ cells while Amicus procedures have a very low platelet contamination, especially with donors.
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Affiliation(s)
- Gaspare Adorno
- Department of Immunohematology, Tor Vergata University of Rome, Viale Oxford, 81, 00133 Rome, Italy.
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