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Hosoi H, Nakajima S, Tsujimoto H, Murata S, Hori Y, Kuriyama K, Mushino T, Matsunami M, Nishikawa A, Kounami S, Hanaoka N, Sonoki T. Comparison of two apheresis systems for granulocyte collection without hydroxyethyl starch. Vox Sang 2024; 119:62-69. [PMID: 37920933 DOI: 10.1111/vox.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Granulocyte transfusion (GTX) is a treatment option for severe infections in patients with neutropenia. In previous studies, hydroxyethyl starch (HES) was used to enhance red blood cell sedimentation for granulocyte collection (GC). However, there are safety concerns about HES, and HES is not readily available in some countries. Therefore, we compared the granulocyte counts and GC efficiency achieved by two apheresis systems without HES. MATERIALS AND METHODS All consecutive GC procedures performed between July 2011 and March 2018 at our hospital were analysed. COBE Spectra was used until 5 February 2016, and Spectra Optia was used afterwards. HES was not used. RESULTS Twenty-six GC procedures were performed, including 18 performed using COBE Spectra and 8 using Spectra Optia. When Spectra Optia was used, >1 × 1010 neutrophils were collected from seven of the eight (88%) procedures. Although there was no significant difference in the granulocyte yield between COBE Spectra-based and Spectra Optia-based GC procedures, the collection efficiency of Spectra Optia was significantly higher than that of COBE Spectra (p = 0.021). Furthermore, the granulocyte yields of Spectra Optia-based GC tended to be more strongly correlated with the peripheral blood neutrophil count on the day of apheresis than those of COBE Spectra-based GC. CONCLUSION Our results suggest that Spectra Optia achieves greater GC efficiency than COBE Spectra, even without HES. GTX may be a therapeutic option for severe neutropenia, even in places where HES is not available.
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Affiliation(s)
- Hiroki Hosoi
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
- Department of Transfusion Medicine, Wakayama Medical University Hospital, Wakayama, Japan
| | - Shiho Nakajima
- Department of Transfusion Medicine, Wakayama Medical University Hospital, Wakayama, Japan
| | - Hiroshi Tsujimoto
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Shogo Murata
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Yoshikazu Hori
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Kodai Kuriyama
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Toshiki Mushino
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Misako Matsunami
- Department of Transfusion Medicine, Wakayama Medical University Hospital, Wakayama, Japan
| | - Akinori Nishikawa
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
- Department of Transfusion Medicine, Wakayama Medical University Hospital, Wakayama, Japan
| | - Shinji Kounami
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Nobuyoshi Hanaoka
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
- Department of General Medicine, National Hospital Organization Kumamotominami National Hospital, Kumamoto, Japan
| | - Takashi Sonoki
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
- Department of Transfusion Medicine, Wakayama Medical University Hospital, Wakayama, Japan
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Henzan T, Yamauchi T, Yamanaka I, Sakoda T, Semba Y, Hayashi M, Kikushige Y, Mishima H, Ishimura M, Koga Y, Miyamoto T, Ohga S, Akashi K, Maeda T, Kunisaki Y. Granulocyte collection by polymorphonuclear cell-targeting apheresis with medium-molecular-weight hydroxyethyl starch. Int J Hematol 2021; 114:691-700. [PMID: 34453685 DOI: 10.1007/s12185-021-03207-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/06/2021] [Accepted: 08/18/2021] [Indexed: 11/27/2022]
Abstract
Granulocyte transfusion (GTX) is a therapeutic option for patients with prolonged neutropenia suffering from severe infections. Efficient granulocyte collection by apheresis from donors requires clear separation of granulocytes from red blood cells (RBCs), and infusion of high-molecular-weight (MW) hydroxyethyl starch (HES) facilitates RBC sedimentation. Recent research has shown that apheresis with medium-MW HES may prevent adverse effects of high-MW HES on donors, but the rationale for collection with medium-MW HES has yet to be evaluated. To validate the use of medium-MW HES, we first performed experiments with whole blood samples to determine how efficiently high-, medium- and low-MW HES separated granulocytes from RBCs, and found that medium-MW HES was just as efficient as high-MW HES. We also reviewed clinical data of granulocyte apheresis at our institution to evaluate granulocyte yields. Retrospective analysis of granulocyte collection revealed that apheresis with medium-MW HES yielded sufficient granulocytes for GTX and that donor anemia reduced collection efficiency. These results collectively may help us to establish a safer method for apheresis targeting polymorphonuclear granulocytes as an alternative to high-MW HES.
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Affiliation(s)
- Tomoko Henzan
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takuji Yamauchi
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ikumi Yamanaka
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Teppei Sakoda
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuichiro Semba
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masayasu Hayashi
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshikane Kikushige
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiroyuki Mishima
- Department of Medical Technology, Kyushu University Hospital, Fukuoka, 812-8582, Japan
| | - Masataka Ishimura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Yuhki Koga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Takahiro Maeda
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Division of Precision Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Yuya Kunisaki
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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Yoshihara S, Ikemoto J, Onomoto H, Sugiyama H, Okuda N, Fukunaga K, Yoshihara K, Kaida K, Ikegame K, Tamaki H, Okada M, Osugi Y, Yamahara K, Higasa S, Fujimori Y. Impact of the use of hydroxyethyl starch in granulocyte apheresis using Spectra Optia. Transfus Med 2021; 31:365-370. [PMID: 34096118 DOI: 10.1111/tme.12795] [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: 01/02/2021] [Revised: 04/18/2021] [Accepted: 05/16/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the impact of the use of hydroxyethyl starch (HES) in granulocyte apheresis using Spectra Optia. BACKGROUND Granulocyte transfusion (GT) is a therapeutic option for neutropenic patients with severe bacterial or fungal infections. Recent studies in emergency medicine have shown the potential risk of using HES, which is routinely used in granulocyte apheresis to increase yield by sedimenting red blood cells. We hypothesized that the use of a newer device (Spectra Optia) would spare the need for HES. METHODS We retrospectively compared granulocyte apheresis with HES (HES group, n = 89) and without HES (non-HES group, n = 36) using Spectra Optia. RESULTS The granulocyte yield was significantly higher in the HES group (7.3 × 1010 vs. 2.0 × 10, p < 0.01) and was attributed to the difference in collection efficiency (36% vs. 7.7%, p < 0.01). The absolute neutrophil count on the following morning of GT was significantly higher in the HES group than in the non-HES group (2460/μl vs. 505/μl, p < 0.01). There were no significant differences in the occurrence of adverse events between the HES and non-HES groups. The renal function was unchanged in both groups after apheresis. CONCLUSIONS We demonstrated that the advantage of using HES remained unchanged in granulocyte apheresis using Spectra Optia.
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Affiliation(s)
- Satoshi Yoshihara
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan.,Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Junko Ikemoto
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Hitomi Onomoto
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Hiroki Sugiyama
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Noriko Okuda
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Keiko Fukunaga
- Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Kyoko Yoshihara
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan.,Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Katsuji Kaida
- Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Hiroya Tamaki
- Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Masaya Okada
- Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Yuko Osugi
- Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Kenichi Yamahara
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Satoshi Higasa
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan.,Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Yoshihiro Fujimori
- Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Japan.,Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
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Nanya M, Yurugi K, Kato I, Hiramatsu H, Kawabata H, Kondo T, Iemura T, Hishida R, Shibutani E, Matsui K, Nakagawa Y, Niwa N, Kasai Y, Roig JM, Arai Y, Miura Y, Takaori-Kondo A, Maekawa T, Hirai H. Successful granulocyte apheresis using medium molecular weight hydroxyethyl starch. Int J Hematol 2019; 110:729-735. [DOI: 10.1007/s12185-019-02755-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
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Cugno C, Deola S, Filippini P, Stroncek DF, Rutella S. Granulocyte transfusions in children and adults with hematological malignancies: benefits and controversies. J Transl Med 2015; 13:362. [PMID: 26572736 PMCID: PMC4647505 DOI: 10.1186/s12967-015-0724-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/02/2015] [Indexed: 12/22/2022] Open
Abstract
Bacterial and fungal infections continue to pose a major clinical challenge in patients with prolonged severe neutropenia after chemotherapy or hematopoietic stem cell transplantation (HSCT). With the advent of granulocyte colony-stimulating factor (G-CSF) to mobilize neutrophils in healthy donors, granulocyte transfusions have been broadly used to prevent and/or treat life-threatening infections in patients with severe febrile neutropenia and/or neutrophil dysfunction. Although the results of randomized controlled trials are inconclusive, there are suggestions from pilot and retrospective studies that granulocyte transfusions may benefit selected categories of patients. We will critically appraise the evidence related to the use of therapeutic granulocyte transfusions in children and adults, highlighting current controversies in the field and discussing complementary approaches to modulate phagocyte function in the host.
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Affiliation(s)
- Chiara Cugno
- Division of Translational Medicine, Clinical Research Center, Sidra Medical and Research Center, Out-Patient Clinic, Al Luqta Street, Education City North Campus, P.O. Box 26999, Doha, Qatar. .,Department of Pediatric Hematology and Oncology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
| | - Sara Deola
- Division of Translational Medicine, Clinical Research Center, Sidra Medical and Research Center, Out-Patient Clinic, Al Luqta Street, Education City North Campus, P.O. Box 26999, Doha, Qatar. .,Hematology and Bone Marrow Transplant Unit, Ospedale Centrale Bolzano, Bolzano, Italy.
| | - Perla Filippini
- Deep Immunophenotyping Core, Division of Translational Medicine, Sidra Medical and Research Center, Doha, Qatar.
| | - David F Stroncek
- Cell Processing Section, Department of Transfusion Medicine, National Institutes of Health (NIH) Clinical Center, Bethesda, MD, USA.
| | - Sergio Rutella
- Division of Translational Medicine, Clinical Research Center, Sidra Medical and Research Center, Out-Patient Clinic, Al Luqta Street, Education City North Campus, P.O. Box 26999, Doha, Qatar.
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