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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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Ravi P, Patel H, Pomrenke S. Apheresis at the National Institutes of Health: A unique nursing experience. Transfus Apher Sci 2021; 60:103205. [PMID: 34272154 DOI: 10.1016/j.transci.2021.103205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The National Institutes of Health (NIH) Clinical Center (CC) is the largest hospital in the world dedicated entirely to clinical research. For over 50 years, NIH scientists have been involved in the development and refinement of apheresis technology that is essential for new and emerging clinical applications of immunotherapy and personalized medicine. NIH investigators have studied the structure and function of blood cells, looking for characteristics that can be exploited to create these new and innovative therapies. Since the very beginning, NIH apheresis nurses have played a pivotal role in providing the raw materials needed for these innovations. The NIH CC Department of Transfusion Medicine (DTM) provides essential services to support investigators and patients when apheresis nurses collect Hematopoietic Progenitor Cells (HPCs), lymphocytes, platelets, plasma and granulocytes from patients and donors enrolled in clinical research protocols at NIH. While balancing patient safety needs, regulatory requirements and research protocol integrity, DTM apheresis nurses face unique challenges.
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Affiliation(s)
- Prabu Ravi
- Clinical Center Nursing Department, National Institutes of Health, Bethesda, MD, United States.
| | - Hemaxi Patel
- Leidos Biomedical Research Inc, Bethesda, MD, United States.
| | - Sylvia Pomrenke
- Clinical Center Nursing Department, National Institutes of Health, Bethesda, MD, United States
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Doblinger N, Gruber M, Ahrens N. Granulozytentransfusion: Update 2020. TRANSFUSIONSMEDIZIN 2020. [DOI: 10.1055/a-1090-0369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungDie therapeutische Anwendung von Granulozytenkonzentraten erfolgt im klinischen Alltag im Gegensatz zu der anderer Blutprodukte nur selten und unregelmäßig. Der zurückhaltende Einsatz beruht unter anderem auf dem Fehlen einer breiten Evidenz, logistischen und wirtschaftlichen Problemen und dem Vorhandensein anderer potenter Therapieoptionen neutropener Infektionen. Dennoch gab es in den letzten Jahren neue wissenschaftliche Erkenntnisse nicht nur zu Physiologie und Pathophysiologie der Granulozyten, wie neu charakterisierten zellulären Verteidigungsstrategien oder deren Mitwirkung bei thrombotischen oder malignen Ereignissen, sondern auch zu deren therapeutischem Effekt. Dieser wird von einer Vielzahl an Parametern, wie der Art der Infektion, dem Transfusionszeitpunkt und der Dosis, beeinflusst. Das macht die Indikationsstellung zu einer komplexen Einzelfallentscheidung und es gilt, die heterogene Datenlage systematisch zusammenzufassen. Außerdem wurden die etablierten
Indikationen neutropener bzw. neutropathischer Infektionen um experimentelle, mögliche neue Anwendungsgebiete wie die Mukositis oder Leukämiebehandlung erweitert. Die erfolgreiche Anwendung setzt eine geeignete, moderne Herstellungsweise voraus. Neben der Apherese, bei der eine relativ hohe Spenderbelastung unter anderem durch Nebenwirkungen von Mobilisationsregime und Sedimentationsbeschleunigern berücksichtigt werden muss, existieren weitere Verfahren wie die Gewinnung von Granulozyten aus Buffy Coats von Vollblutspenden. Diese versprechen eine Reduktion logistischer Probleme und unerwünschter Wirkungen auf den Spender. Unerwünschte Wirkungen bei Empfängern von Granulozytentransfusionen sollten nach wie vor berücksichtigt und gegen einen erhofften therapeutischen Effekt abgewogen werden.
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Affiliation(s)
- Nina Doblinger
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg
| | - Michael Gruber
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg
| | - Norbert Ahrens
- Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsklinikum Regensburg
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