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Watanaboonyongcharoen P, Lorucharoen N, Wudhikarn K, Bunworasate U, Chanswangphuwana C, Rojnuckarin P. Combined peripheral blood monocyte count and white blood cell count as a guide for successful one-day autologous peripheral blood stem cell collection. Int J Lab Hematol 2024. [PMID: 39074488 DOI: 10.1111/ijlh.14351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION Peripheral blood stem cells (PBSCs) are the most common source of stem cell transplantation, which depends on an adequate number of CD34+ cells. Although pre-apheresis CD34+ cell count is a standard guide for the collection, it is not always available. This study aimed to evaluate complete blood count parameters for predicting successful one-day autologous PBSC collection. METHODS Data from the patients who underwent autologous PBSC collection at a tertiary care hospital were retrospectively reviewed. RESULTS There were 123 patients (185 leukapheresis procedures). Successful PBSC collection (CD34+ cells ≥4.0 × 106 cells/kg) was obtained in 85 patients (69.1%), of which 55 (44.7%) were successfully obtained on the first day. The median CD34+ collection efficiency was 44.1%. The mean platelet loss during apheresis was 39.9%. The adverse event rate was 18.9%. Patients in whom PBSCs were collected within one day were less likely to experience adverse effects related to leukapheresis. Pre-apheresis CD34+ cells ≥10 cells/μLand combined white blood cell (WBC) counts ≥5 × 109/L and/or monocyte ≥10% were independently associated with the successful one-day PBSC collection (adjusted odds ratio 24.06, 95% confidence interval [CI] 5.30-109.10, p < 0.001; and 6.94, 95% CI 1.35-35.79, p = 0.021, respectively). Only pre-apheresis CD34+ cells had a strong correlation with the total stem cell yield. CONCLUSIONS To reduce the complication of leukapheresis, the combined pre-apheresis WBC ≥5 × 109/L and/or monocyte ≥10% is a practical parameter to initiate a successfully one-day PBSC collection with or without pre-apheresis CD34+ cell results.
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Affiliation(s)
- Phandee Watanaboonyongcharoen
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Renal Immunology and Renal Transplant Research Unit, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nattarat Lorucharoen
- Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Kitsada Wudhikarn
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Udomsak Bunworasate
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chantiya Chanswangphuwana
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ponlapat Rojnuckarin
- Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Murugesan M, Shringarpure K, Karthickeyan DSA, Nair CK, Nayanar SK, Venugopal V, Selvaraj K, Rathi P, Mehta KG, Deenathayalan V, Gayathiri KC. Clinical and equipment-related factors associated with the adequate peripheral blood stem cell collection in autologous transplant at a tertiary cancer center in Kerala - A retrospective cohort study. Transfus Apher Sci 2019; 58:457-463. [PMID: 31255504 DOI: 10.1016/j.transci.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/01/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND PBSC collection using apheresis is the preferred source of hematopoietic stem cells transplantation. However, apheresis procedures fail to harvest adequate CD34 yield in 5 to 40% of patients during the first collection. Therefore, this study aimed to study both the clinical- and equipmentrelated factors influencing CD34 yield among the autologous patients and to compare the collection efficiency of two apheresis equipments(Haemonetics MCS+ and Terumo Spectra Optia). METHODS Retrospective analysis of 69 patients underwent PBSC collection from 2015 to 2018. Frequency, clinical- and equipment-related factors responsible for adequate CD34+ cells (≥2 x106 cells/kg) yield during the first collection was studied. Factors such as collection efficiency, percentage platelet loss and percentage hemoglobin loss were considered to compare the two apheresis system. RESULTS Two-third (72%) patients of the study population had adequate CD34 stem cells yield during the first collection. Factors such as exposure to lenalidomide-based pretreatment regimen, peripheral blood WBC count and CD34 count are associated with the adequate CD34 yield. Optia had a slightly better collection efficiency than MCS+ (50 and 44; p=0.37). Optia had lower product volume (237 vs 298 ml) and lesser procedure duration (277 vs 360 min), whereas the median Hb loss (3.0% and 2.3%) and mean platelet loss (49% and 34%) were higher with MCS. CONCLUSION This study infers that the collection efficiency of both the equipments in collecting CD34 stem cells was similar. However, during PBSC collection, procedures using Optia can be preferred to MCS+ on the patients with risk of anemia and thrombocytopenia.
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Affiliation(s)
- M Murugesan
- Dept. of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India.
| | | | | | - C K Nair
- Dept. of Clinical Hematology, Malabar Cancer Centre, Thalassery, Kerala, India
| | - S K Nayanar
- Dept. of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India
| | - V Venugopal
- Dept. of Community Medicine, Sri Manakula Vinayagar Medical College, Puducherry, India
| | - K Selvaraj
- Dept. of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - P Rathi
- Dept. of Community Medicine, Kasturba Medical College, Mangalore, India
| | - K G Mehta
- Community Medicine Department, GMERS Medical college Gotri, Vadodara, India
| | | | - K C Gayathiri
- Dept. of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India
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Tanaka Y, Ohishi K, Sawai T, Iwasaki H, Kageyama S, Masuya M, Matsumoto T, Tanigawa T, Wada H, Shiku H, Ito M, Katayama N. Attempt to Harvest a Sufficient Number of Mononuclear Cells in an Appropriate Blood Product Volume By Modification of the Default Apheresis Setting. Ther Apher Dial 2017; 21:507-511. [PMID: 28731276 DOI: 10.1111/1744-9987.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/29/2017] [Accepted: 04/21/2017] [Indexed: 11/30/2022]
Abstract
To harvest for T cell therapy, a 1.6-fold higher number of CD3+ T cells was collected with MNC mode (N = 10) compared with Auto PBSC mode (N = 5) in COBE Spectra cell separator, but the blood product volume was increased by 3.5-fold. For therapeutic angiogenesis therapy, apheresis was initially performed using Auto PBSC mode (N = 4) to fine tune the blood product volume to omit cell concentration, but the collected number of mononuclear cells was lower than expected. However, an increase of the harvest cycle number from 3.8 ± 0.5 to 7.4 ± 2.0 cycles (N = 19) resulted in a 2.1-fold higher number of collected mononuclear cells (8.7 ± 4.1 × 109 vs. 4.1 ± 1.0 × 109 cells, P < 0.05). The increase in blood product volume by this modification appeared to be lower than that expected with MNC mode. These data show that optimal harvesting can be achieved by modification of default collection settings.
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Affiliation(s)
- Yumi Tanaka
- Blood Transfusion Service, Mie University Hospital, Tsu, Mie, Japan
| | - Kohshi Ohishi
- Blood Transfusion Service, Mie University Hospital, Tsu, Mie, Japan
| | - Toshiki Sawai
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hitoshi Iwasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Shinichi Kageyama
- Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masahiro Masuya
- Departments of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | | | - Takashi Tanigawa
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hideo Wada
- Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hiroshi Shiku
- Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Naoyuki Katayama
- Departments of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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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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Tiwari AK, Pandey P, Subbaraman H, Bhargava R, Rawat G, Madiraju S, Raina V, Bhargava R. Autologous peripheral blood stem cell harvest: Collection efficiency and factors affecting it. Asian J Transfus Sci 2016; 10:93-7. [PMID: 27011680 PMCID: PMC4782504 DOI: 10.4103/0973-6247.164273] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Harvest of hematopoietic progenitor cells via leukapheresis is being used increasingly for transplants in India. Adequate yield of cells per kilogram body weight of recipient is required for successful engraftment. Collection efficiency (CE) is an objective quality parameter used to assess the quality of leukapheresis program. In this study, we calculated the CE of the ComTec cell separator (Fresenius Kabi, Germany) using two different formulae (CE1 and CE2) and analyzed various patient and procedural factors, which may affect it. MATERIALS AND METHODS One hundred and one consecutive procedures in 77 autologous donors carried out over 3 years period were retrospectively reviewed. Various characteristics like gender, age, weight, disease status, hematocrit, preprocedure total leukocyte count, preprocedure CD34 positive (CD34+) cells count, preprocedure absolute CD34+ cell count and processed apheresis volume effect on CE were compared. CE for each procedure was calculated using two different formulae, and results were compared using statistical correlation and regression analysis. RESULTS The mean CE1 and CE2 was 41.2 and 49.1, respectively. CE2 appeared to be more accurate indicator of overall CE as it considered the impact of continued mobilization of stem cells during apheresis procedure, itself. Of all the factors affecting CE, preprocedure absolute CD34+ was the only independent factor affecting CE. CONCLUSION The only factor affecting CE was preprocedure absolute CD34+ cells. Though the mean CE2 was higher than CE1, it was not statistically significant.
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Affiliation(s)
- Aseem K Tiwari
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon, Haryana, India
| | - Prashant Pandey
- Department of Transfusion Medicine, Jaypee Hospital, Sector-128, Noida, Uttar Pradesh, India
| | - Harini Subbaraman
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon, Haryana, India
| | - Rahul Bhargava
- Department of Hemato-Oncology, Artemis Hospital, Sector-51, Gurgaon, Haryana, India
| | - Ganesh Rawat
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon, Haryana, India
| | - Shivani Madiraju
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon, Haryana, India
| | - Vimarsh Raina
- Department of Transfusion Medicine, Medanta-The Medicity, Sector-38, Gurgaon, Haryana, India
| | - Richa Bhargava
- Department of Gastroenterology, Artemis Hospital, Sector-51, Gurgaon, Haryana, India
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Kim SR, Choung HK, Kim DW, Sung KW, Kang ES. Evaluation of a new cell separator for collection of peripheral blood CD34+ progenitor cells in pediatric patients. Transfusion 2010; 51:306-12. [PMID: 20804528 DOI: 10.1111/j.1537-2995.2010.02864.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study was conducted to evaluate the performance of the COM.TEC cell separator (Fresenius HemoCare GmbH) for collecting CD34+ cells in pediatric patients who were intended to have autologous peripheral blood progenitor cell transplantation, with respect to collection variables, prediction power of CD34+ cell yield, and influence on donors. STUDY DESIGN AND METHODS A total of 26 pediatric solid tumor patients who received mobilization chemotherapy and granulocyte-colony-stimulating factor underwent CD34+ cell collection (n = 96) using the COM.TEC auto mononuclear cell (MNC) program. Patients were divided into a neuroblastoma (NBL) group and a brain tumor group according to the intensity of prior chemotherapy regimens. The collection variables, cellular variables of leukapheresis products, and the peripheral blood cell counts of patients were compared with those acquired using the COBE Spectra (GambroBCT). The CD34+ cell collection efficiency (CE) and the percentage ratios of actual to predicted CD34+ cell yield indicating prediction power were analyzed. RESULTS Using the COM.TEC auto MNC program, the processing rate was higher and the product volume was smaller (p < 0.05) than those of the COBE Spectra. Platelet (PLT) reduction in peripheral blood and PLT contamination of the products were significantly lower (p < 0.01). The median CE was less than 60% in both patient groups (50.0 and 48.4%, respectively). The actual collected CD34+ cell yields were medians of 66.9 and 76.1% of the predicted values in NBL group and brain tumor group, respectively. CONCLUSION PBPC collections by the COM.TEC cell separator had advantages of high processing rate, low product volume, and low contamination by PLTs of product. Low PLT loss was observed in pediatric patients who need to collect autologous PBPCs. However, applying CD34+ cell yield prediction was not practical for prospective scheduling of the next collection. More specified data need to be accumulated for more accurate prediction of CD34+ cell yield in pediatric patients.
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Affiliation(s)
- Suk-Ran Kim
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Perseghin P, Terruzzi E, Dassi M, Baldini V, Parma M, Coluccia P, Accorsi P, Confalonieri G, Tavecchia L, Verga L, Ravagnani F, Iacone A, Pogliani EM, Pioltelli P. Management of poor peripheral blood stem cell mobilization: incidence, predictive factors, alternative strategies and outcome. A retrospective analysis on 2177 patients from three major Italian institutions. Transfus Apher Sci 2009; 41:33-7. [PMID: 19540167 DOI: 10.1016/j.transci.2009.05.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CD34+ peripheral blood hematopoietic stem cells (HSC) are usually collected following mobilization therapy accomplished by using growth factors (GF) such as rHuG-CSF or rHuGM-CSF with or without chemotherapy. A target dose of yielded CD34+ is usually prescribed by the attending physician depending on different protocols, which may include single or double transplantation. HSC collection usually is performed when at least 20 CD34+ HSC/microL are detected by means of flow cytometry. A cumulative dose of at least 2 x 10(6)/Kg/bw CD34+ HSC has been considered as the threshold to allow a prompt and persistent hematopoietic recovery. Unfortunately, this goal is not achieved by the totality of patients undergoing mobilization regimen. In fact, 5-46% of patients who underwent mobilization therapy fail HSC collection due to very low peripheral blood HSC CD34+ count. Patients' characteristics, including age, sex, stage of the underlying disease (complete or partial remission), diagnosis, previously administered radio/chemotherapy regimens, time-lapse from last chemotherapy before mobilization and mobilization schedule (including dose of GF) were considered as possibly predictive of poor or failed mobilization. We performed a retrospective analysis in 2177 patients from three large Italian academic institutions to assess the incidence of poor mobilizers within our patients' series. Therefore, a patient who fails a first mobilization (and when an HLA-compatible related on unrelated donor is not available) could undergo a second attempt either with different mobilization schedule or by using different GF, such as stem cell factor, growth hormone (GH), or more recently newly introduced drugs such as AMD3100, alone or in combination with rHuG- or -rHuGM-CSF. Thus, we investigated the fate of those who failed a first mobilization and subsequently underwent a second attempt or alternative therapeutic approaches.
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Affiliation(s)
- Paolo Perseghin
- Unità di Aferesi e nuove Tecnologie Trasfusionali-Servizio Trasfusionale, Dipartimento di Patologia Clinica, Ospedale San Gerardo de'Tintori, Monza, Italy.
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Chen Y, Hoecker P, Zeng J, Dettke M. Combination of Cobe AutoPBSC and Gambro Elutra as a platform for monocyte enrichment in dendritic cell (DC) therapy: Clinical study. J Clin Apher 2008; 23:157-62. [DOI: 10.1002/jca.20173] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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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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11
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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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Strasser EF, Hendelmeier M, Weisbach V, Zimmermann R, Ringwald J, Juntke R, Sauer G, Zingsem J, Eckstein R. CD14+ cell collection in non-cytokine-stimulated donors with the COM.TEC cell separator. Transfusion 2006; 46:66-73. [PMID: 16398732 DOI: 10.1111/j.1537-2995.2006.00682.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COM.TEC cell separator (Fresenius Hemocare), equipped with the MNC program (single-stage chamber) and the PBSC-LYM program (dual-stage chamber), was evaluated for CD 14+ cell collection regarding cell yields, collection efficiencies (CEs), and the content of residual cells in harvests. STUDY DESIGN AND METHODS Twenty-four non-cytokine-stimulated donors underwent 5-L mononuclear cell (MNC) collections on the COM.TEC device to compare both programs. Two software versions (v02.03.05 vs. v 03.00.04) were investigated for optimization of the CD 14+ cell collection process. Blood counts of donors and products were analyzed for CD 14+ cells by flow cytometry and for platelets (PLTs), white blood cells, and red blood cells (RBCs) by a blood cell counter. RESULTS In 5-L collections, the MNC program resulted in high CEs (83+/- 23%) and yields (1.2 x 10(9)+/- 0.6 x 10(9) per unit) of CD 14+ cells, but the products showed high residual PLTs. The use of a dual-stage chamber in the PBSC-LYM program produced a low content of residual PLTs (0.7 x 10(11) +/- 0.3 x 10(11) per unit) and RBCs but failed to reach a target of 1 x 10(9) CD 14+ cells. Modulated light to stabilize the buffy-coat detection by the interface monitor significantly improved CD 14+ cell enrichment. By use of the PBSC-LYM program, higher centrifuge velocity (1700 rpm [382 x g] vs. 1500 rpm [297 x g]) improved significantly CD 14+ cell yields (0.7 x 10(9) vs. 0.5 x 10(9) cells). CONCLUSION A pure CD 14+ cell product with low numbers of residual cells was obtained by the PBSC-LYM program, which could be useful for good manufacturing practice-conformed production within closed systems. The MNC program offers the collection of high CD 14+ cell yields with excellent CEs but also high residual PLT counts.
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Affiliation(s)
- Erwin F Strasser
- Department of Transfusion Medicine and Hemostaseology, University Hospital, FAU Erlangen-Nürnberg, Germany.
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Reddy RL. Mobilization and collection of peripheral blood progenitor cells for transplantation. Transfus Apher Sci 2005; 32:63-72. [PMID: 15737875 DOI: 10.1016/j.transci.2004.10.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/01/2004] [Indexed: 11/28/2022]
Abstract
Bone marrow transplantation gradually expanded as a treatment modality for various malignant and non malignant disease conditions. Since the discoveries of the potential of Peripheral Blood Progenitor Cells (PBPC) in the hematopoietic reconstitution mid 1980s and early 1990s PBPC gradually replaced bone marrow as the preferred source of stem cells. The introduction of hematopoietic cytokines that can mobilize large number of progenitors into circulation accelerated PBPC usage. Technological advancements in the apheresis instrumentation greatly helped in the conversion from marrow to PBPC. PBPC collection is less painful, less expensive and transplant with PBPC results in faster hematological recovery than with marrow. Almost all of the autologous transplants are currently performed with PBPC and a similar trend is seen with the allogeneic transplants. The progenitor cell mobilization regimen for autologous patients can be cytokines alone or cytokines combined with chemotherapy. In the majority of the patients the required minimal cell dose of 2.5-5.0 x 10(6)/kg CD34+ cells can be collected in one or two apheresis collections. A few of autologous transplant patients who mobilize poorly require several collections. Allogeneic donors are generally mobilized with daily subcutaneous injections of G-CSF 10 microg/kg for 5 days. The PBPC are collected in one or two apheresis procedures. The side effects of G-CSF are generally mild to moderate; however rare serious reactions including rupture of the spleen have been reported. The collection of PBPC in pediatric patients poses additional challenges yet an adequate dose of cells can be collected with the available apheresis instrumentation. The apheresis collection procedures are safe with no serious adverse consequences. Future scientific advancements may expand the use of PBPC for other clinical application in addition to the current use for hematological reconstitution.
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Affiliation(s)
- Ramakrishna L Reddy
- American Red Cross Midwest Region Blood Services and Department of Pathology and Microbiology, University of Nebraska Medical Center, 3838 Dewey Avenue, Omaha, NE 68105, USA.
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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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15
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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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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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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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