1
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Rogers KJ, Mott SL, Parsons MG, Schlueter AJ. Use of subgroup-specific hematopoietic stem cell collection efficiencies to improve truncation calculations for large-volume leukapheresis procedures. J Clin Apher 2023; 38:664-676. [PMID: 37526046 DOI: 10.1002/jca.22077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE A critical component of optimizing peripheral blood (PB) hematopoietic stem cell (HSC) collections is accurately determining the processed blood volume required to collect the targeted number of HSCs. Fundamental to most truncation equations employed to determine this volume is the procedure's estimated collection efficiency (CE), which is typically applied uniformly across all HSC collections. Few studies have explored the utility of using different CEs in subpopulations of donors that have substantially different CEs than the institutional average. METHODS Initial procedures from 343 autologous and 179 allogeneic HSC collections performed from 2018 to 2021 were retrospectively analyzed. Predictive equations were developed to determine theoretical truncation rates in various donor subgroups. RESULTS Quantitative variables (pre-procedure cell counts) and qualitative variables (relatedness to recipient, gender, method of venous access, and mobilization strategy) were found to significantly impact CE. However, much of the variability in CE between donors could not be explained by the variables assessed. Analyses of procedures with high pre-collection PB cell counts identified lower CE values for these donors' truncation equations which still allow truncation but minimize risk of collecting less CD34+ cells than requested. CONCLUSIONS Individualized CE does not substantially improve truncation volume calculations over use of a fixed CE and adds complexity to these calculations. The optimal fixed CE varies between autologous and allogeneic donors, and donors with high pre-collection PB cell counts in either of these groups. This model will be clinically validated and continuously refined through analysis of future HSC collections.
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Affiliation(s)
- Kai J Rogers
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA
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2
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Sumii Y, Fujii K, Kondo T, Urata T, Kimura M, Fujiwara H, Asada N, Ennishi D, Nishimori H, Matsuoka KI, Otsuka F, Maeda Y, Fujii N. Evaluating the efficiency and safety of large-volume leukapheresis using the Spectra Optia continuous mononuclear cell collection protocol for peripheral blood stem cell collection from healthy donors: A retrospective study. Transfusion 2023; 63:2120-2130. [PMID: 37792312 DOI: 10.1111/trf.17563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Large-volume leukapheresis (LVL) refers to processing of more than three volumes of blood in a single session for peripheral blood stem cell collection. Recently, continuous mononuclear cell collection (cMNC) protocol has been developed using the Spectra Optia system, which is a widely used apheresis device. LVL using the novel protocol has been investigated in patients. However, the efficiency and safety of LVL in healthy donors using this protocol has not been characterized. Therefore, this study aimed to evaluate the efficiency and tolerability of CD34+ collection of LVL with the cMNC protocol in healthy donors. STUDY DESIGN AND METHODS We retrospectively collected data on LVL (>3 total blood volume) and normal-volume leukapheresis (NVL) performed in healthy donors between October 2019 and December 2021. All procedures were performed using the cMNC protocol. RESULTS Although pre-apheresis CD34+ cell count was lesser in LVL (23.5 vs. 58.0/μL, p < .001), CD34+ collection efficiency was comparable between LVL and NVL (61.2% vs. 61.4%, p = .966). Platelet loss was significantly higher in LVL compared to NVL (38.0% vs. 29.4%, p < .001), with no correlation between attrition of platelet and processing blood volume. Moreover, the incidence of citrate toxicity during procedures was comparable between the two groups (31.6% vs. 21.4%, p = .322). All LVL procedures could be completed without any adverse events. CONCLUSION Allogeneic LVL procedure using Spectra Optia cMNC protocol was well tolerated by the donors and resulted in efficient collection of CD34+ cells, which was comparable to that of NVL.
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Affiliation(s)
- Yuichi Sumii
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keiko Fujii
- Division of Clinical Laboratory, Okayama University Hospital, Okayama, Japan
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Takumi Kondo
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Tomohiro Urata
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Maiko Kimura
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ennishi
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Division of Clinical Laboratory, Okayama University Hospital, Okayama, Japan
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshinobu Maeda
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobuharu Fujii
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
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3
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Miller A, Davies J, Young K, Eckman E, Lo MY, Erskine H, Knutson L, Ondricek S, Margolis JM, Auletta JJ, Miller JP, Stefanski HE, Devine S, Pham HP. The effect of increased collect pump rate on collection efficiency in hematopoietic progenitor cell collection by apheresis in allogeneic adult donors-A single center analysis. Transfusion 2023; 63:1926-1936. [PMID: 37668194 DOI: 10.1111/trf.17533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Optimizing CD34 recovery while minimizing harm to hematopoietic progenitor cell donors by apheresis (HPC(A) donors) is critical to the success of allogeneic hematopoietic cell transplantation. We examined the efficacy and safety of starting allogeneic HPC(A) donors at a collect pump rate (CPR) of 2 mL/min on the Spectra Optia regardless of the inlet flow rate and/or pre-apheresis white blood cell (WBC) count (high CPR group). STUDY DESIGN AND METHODS A single-center retrospective study was performed on allogeneic adult donors from 10/2020 to 12/2022. From 10/2020 to 6/19/2022, all donors had CPR of ~1 mL/min (historical group). High CPR group started 6/20/2022. RESULTS During the study period, 412 donors were in historical group versus 196 (32.2%) in high CPR group. Median CD34 collection efficiency (CE) was higher and more consistent in high CPR group (55.1% vs. 53% in historical group, p < .0001) and remained significant in multivariate analysis. Although product volume was higher in high CPR group, WBC, hematocrit, and platelet concentrations were significantly lower. No difference in engraftment outcomes in patients receiving products from two groups was observed. Moreover, no differences occurred in a significant peri-procedural adverse event or percent decrease in platelets (6.87% decrease in platelets per 100 × 106 CD34 cells collected versus 6.66% in historical group, p = .89). Furthermore, high CPR group had ~26 min less in collection time for every 100 × 106 CD34 cells collected, resulting in less positive fluid balances. CONCLUSIONS Starting allogeneic HPC(A) donor collection at a CPR of 2 mL/min is safe and effective.
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Affiliation(s)
- Anthony Miller
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Jeramy Davies
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Kathryn Young
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Emily Eckman
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Melissa Y Lo
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Hannah Erskine
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Lisa Knutson
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Sara Ondricek
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
| | - Jamie M Margolis
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
| | | | - John P Miller
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
| | | | - Steven Devine
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
| | - Huy P Pham
- National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA
- Be The Match Seattle Apheresis Collection Center, Seattle, Washington, USA
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4
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Rahim MQ, Goebel WS, Delph J, Soundar E. Primed for change: The effect of a blood prime on peripheral blood stem cell collection and accuracy of a prediction tool in pediatric patients. J Clin Apher 2023; 38:540-547. [PMID: 37243380 DOI: 10.1002/jca.22057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Abstract
Pediatric apheresis collection of peripheral blood stem cells for autologous transplantation often requires use of a blood prime. We evaluated the relationship between pre-apheresis blood CD34+ counts and final CD34+ yield with use of a blood prime. Forty patients underwent apheresis stem cell collection in a 5 year period in our hospital, of which 27 required blood priming of the apheresis machine. Despite the blood prime group having significantly higher pre-apheresis CD34+ cell counts, this group processed a relatively higher volume of blood due to a higher dilutional effect and collected significantly less than predicted CD34+ cell yield. Use of weight-specific collection efficiencies and dilution-adjusted pre-apheresis CD34+ counts will help in accurately estimating the whole blood volume to process for PBSC collection and therefore increase efficiency and decrease the overall cost of collection.
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Affiliation(s)
- Mahvish Q Rahim
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
- Indiana University School of Medicine, Indianapolis, Indiana, USA
- Pediatric Hematology, Oncology and Stem Cell Transplantation, Indianapolis, Indiana, USA
| | - W Scott Goebel
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
- Indiana University School of Medicine, Indianapolis, Indiana, USA
- Pediatric Hematology, Oncology and Stem Cell Transplantation, Indianapolis, Indiana, USA
- Indiana University Health Apheresis Program, Indianapolis, Indiana, USA
| | - John Delph
- Indiana University Health Apheresis Program, Indianapolis, Indiana, USA
| | - Esther Soundar
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, USA
- Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana University Health Apheresis Program, Indianapolis, Indiana, USA
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5
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Kondo T, Fujii N, Fujii K, Sumii Y, Urata T, Kimura M, Matsuda M, Ikegawa S, Washio K, Fujiwara H, Asada N, Ennishi D, Nishimori H, Matsuoka KI, Otsuka F, Maeda Y. Low hematocrit reduces the efficiency of CD34 + cell collection when using the Spectra Optia continuous mononuclear cell collection procedure. Transfusion 2022; 62:1065-1072. [PMID: 35322885 DOI: 10.1111/trf.16856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND CD34+ cell collection efficiency (CE) is the determining factor when calculating processed blood volume (PBV) for leukapheresis (LP). However, the factors affecting CE in the continuous mononuclear cell collection (cMNC) protocol performed by the Spectra Optia apheresis system are not well established. STUDY DESIGN AND METHODS We retrospectively collected the data from 147 consecutive apheresis procedures across 106 healthy donors and 27 patients completed between July 2016 and December 2020 at the Okayama University Hospital. All procedures were performed using the Optia cMNC protocol. RESULTS The median CD34+ CE2 was significantly higher in the donor samples (64.3%) than in the patient samples (46.8%) (p < .0001). WBC counts, hematocrit, and platelet counts were all significantly higher in the donors than in the patients, and there was a moderate positive correlation between CD34+ CE2 and hematocrit (r = .47, p < .0001), with the equation of the line being y = 1.23x + 12.23. In contrast, there was only a very weak correlation between CD34+ CE2 and WBC or platelet count. In addition, low hematocrit correlated with an increased time to interface formation. CONCLUSION These data revealed the negative impact of low hematocrit on the efficiency of CD34+ cell collection when using the Optia cMNC protocol and suggest that hematocrit values should also be considered when determining PBV.
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Affiliation(s)
- Takumi Kondo
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Nobuharu Fujii
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Keiko Fujii
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Division of Clinical Laboratory, Okayama University Hospital, Okayama, Japan
| | - Yuichi Sumii
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Tomohiro Urata
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Maiko Kimura
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Masayuki Matsuda
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Shuntaro Ikegawa
- Division of Transfusion, Okayama University Hospital, Okayama, Japan.,Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Kana Washio
- Department of Pediatrics/Pediatric Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan.,Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Fumio Otsuka
- Division of Clinical Laboratory, Okayama University Hospital, Okayama, Japan.,Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
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6
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Avecilla ST, Boulad F, Yazdanbakhsh K, Sadelain M, Shi PA. Process and procedural adjustments to improve CD34+ collection efficiency of hematopoietic progenitor cell collections in sickle cell disease. Transfusion 2021; 61:2775-2781. [PMID: 34160085 DOI: 10.1111/trf.16551] [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: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Adequate CD34+ collection efficiency (CE) is critical to achieve target CD34+ cell doses in hematopoietic progenitor cell (HPC) collections. Autologous HPC collection in sickle cell disease (SCD) is associated with unstable collection interfaces and low CD34+ CEs. We hypothesized that variables specific to SCD, activation of blood cells and elevated viscosity, might contribute to these issues and made adjustments to the collection process and procedure to address our hypothesis. STUDY DESIGN AND METHODS In two patients with SCD undergoing autologous HPC collection on our clinical trial (NCT02193191), we therefore implemented adjustments to the process and procedure in the following areas: proximity of RBC exchange to HPC collection, the type of anticoagulation, and the packing factor setting. RESULTS There was no collection interface instability. Our CD34+ CE1s were high at 70% and 51%, and granulocyte CE, platelet CE, and product granulocyte % were remarkably low. Product hematocrits were not as high as previously reported to be required to obtain adequate CEs. Interestingly, one HPC product showed a hemoglobin S (HbS) of 91% at the same time that the peripheral blood (PB) showed a HbS of 22%. DISCUSSION Adjustments to the HPC collection process and procedure were associated with adequate CD34+ CEs and low granulocyte and platelet contamination in HPC products from SCD patients. Given the discrepancy in the percentage of sickle RBCs in the product versus the PB, we hypothesize that CD34+ cells and RBCs may aggregate. Our interventions and hypothesis should be further investigated in larger studies.
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Affiliation(s)
- Scott T Avecilla
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Farid Boulad
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Karina Yazdanbakhsh
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA
| | - Michel Sadelain
- Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Patricia A Shi
- Lindsley F. Kimball Research Institute (NYBC), Sickle Cell Program, Division of Hematology, Albert Einstein College of Medicine, Bronx, New York, USA
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7
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Optimizing leukapheresis product yield and purity for blood cell-based gene and immune effector cell therapy. Curr Opin Hematol 2021; 27:415-422. [PMID: 32889828 DOI: 10.1097/moh.0000000000000611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW A critical common step for blood-based ex-vivo gene and immune effector cell (IEC) therapies is the collection of target cells for further processing and manufacturing, often accomplished through a leukapheresis procedure to collect mononuclear cells (MNCs). The purpose of this review is to describe strategies to optimize the apheresis product cell yield and purity for gene and IEC therapies. Relevant data from the conventional bone marrow transplant literature is described where applicable. RECENT FINDINGS Product yield is affected by three main factors: the peripheral blood concentration of the target cell, optimized by mobilizing agents, donor interventions or donor selection; the volume of peripheral blood processed, tailored to the desired product yield using prediction algorithms; and target cell collection efficiency, optimized by a variety of device and donor-specific considerations. Factors affecting product purity include characteristics of the donor, mobilizing agent, device, and device settings. SUMMARY Strategies to optimize product yield and purity for gene and IEC therapies are important to consider because of loss of target cell numbers or function with downstream steps and detrimental effects of nontarget cells on further manufacturing and patient outcome.
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Pham HP, Dormesy S, Wolfe K, Budhai A, Sachais BS, Shi PA. Potentially modifiable predictors of cell collection efficiencies and product characteristics of allogeneic hematopoietic progenitor cell collections. Transfusion 2021; 61:1518-1524. [PMID: 33713454 DOI: 10.1111/trf.16370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hematopoietic progenitor cell (HPC) and immune effector cell (IEC) therapies often require high doses of mononuclear cells (MNCs), whether CD34+ cells, lymphocytes, or monocytes. Cells for IEC can be sourced from HPC products. We thus examined potentially modifiable variables affecting collection efficiencies (CEs) of MNC subsets in HPC collection and also of the typically undesired cell types of platelets, granulocytes, and red cells, which hinder downstream processing. Finally, we sought to confirm previously indeterminate studies of the effect of an adjusted collect flow rate (CFR) on CD34+ CE. STUDY DESIGN AND METHODS We performed univariate and multivariate regression analyses of all 135 National Marrow Donor Program (NMDP) HPC collections in 2019 and compared these fixed CFR procedures to previous NMDP collections using adjusted CFRs. RESULTS Target cell CEs decreased with increasing peripheral blood (PB) concentration and were associated with different cell type locations within the MNC layer. CEs of undesired cell types varied with standard procedural parameters (inlet flow rate, whole blood processed, etc.). Interestingly, some CEs increased with preapheresis hematocrit. Finally, adjusting the CFR by PB MNC count improved MNC CE but not CD34+ CE. CONCLUSION Correlation of target cell CEs with their PB concentration and different cell type locations by depth within the MNC layer indicates the importance of investigating the compensatory fine-tuning of procedure variables to improve CE. Correlation of CEs with PB hematocrit, and CFR adjustment by a modified PB MNC and/or PB CD34 algorithm should be further explored. Adjusting standard procedural parameters may reduce product contamination.
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Affiliation(s)
- Huy P Pham
- Be The Match Seatte Collection Center, National Marrow Donor Program, Seattle, Washington, USA
| | | | - Kurt Wolfe
- New York Blood Center, Clinical Services, New York, New York, USA
| | - Alexandra Budhai
- New York Blood Center, Clinical Services, New York, New York, USA
| | - Bruce S Sachais
- New York Blood Center, Clinical Services, New York, New York, USA
- New York Blood Center, Lindsley F. Kimball Research Institute, New York, New York, USA
| | - Patricia A Shi
- New York Blood Center, Clinical Services, New York, New York, USA
- New York Blood Center, Lindsley F. Kimball Research Institute, New York, New York, USA
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9
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Jacob RP, Walsh EM, Maslak PG, Giralt SA, Avecilla ST. A simplified CD34+ based preharvest prediction tool for HPC(A) collection. Transfusion 2021; 61:1525-1532. [PMID: 33694175 DOI: 10.1111/trf.16356] [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: 10/20/2020] [Revised: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hematopoietic stem cell transplantation is an important treatment that is dependent on the collection of sufficient CD34+ hematopoietic progenitor cells. The peripheral blood CD34 count (PB CD34+ counts) measured by flow cytometry can be used in predicting CD34+ stem cell yields hours before the completion of collection. Previously described formulas to predict the yield have used many different variables. As such, there is currently no consensus on an industry-standard algorithm or formula. STUDY DESIGN AND METHODS Retrospective reviews of same-day PB CD34+ counts and the ensuing absolute CD34+ yields of mobilized donors (allogeneic and autologous) were used to develop and validate a formula using regression analysis to predict the CD34+ stem cell yield. A metric of prediction correlation, using root mean square error (RMSE), was used to assess the robustness of our prediction formula in addition to comparisons with two other published formulas, as well as subset analysis. RESULTS A formula in the form of y = mxb with r = 0.95 and 95% confidence intervals was generated and validated. The ratio of actual to predicted yield demonstrated a high correlation coefficient (r = 0.96) with linear regression and overall RMSE of 228.4, which was lower than the two prior studies (calculated RMSE = 330.8 and 405.2). Subset analyses indicated male patients, lymphoma patients, and patients >60 years of age demonstrated lower RMSEs. CONCLUSION We have demonstrated a simple yet robust formula that can be used prospectively to accurately predict the CD34+ stem cell yield in both autologous and allogeneic donors, which also accounts for recipient weight.
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Affiliation(s)
- Reuben P Jacob
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Eileen M Walsh
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Peter G Maslak
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sergio A Giralt
- Division of Hematologic Malignancies, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Scott T Avecilla
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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10
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Brignier A, Ader V, Bellegarde K, Giraud C, Guerout-Verite MA, Hamzy F, Huynh TNP, Levavasseur A, Nacimento F, Rousseau Y, Vincent L, Yakoub-Agha I, De Vos J. Modalités de mobilisation des cellules souches hématopoïétiques autologues et objectifs cellulaires en cellules CD34 + : recommandations de la Société francophone de greffe de mœlle et de thérapie cellulaire (SFGM-TC). Bull Cancer 2020; 107:S44-S51. [DOI: 10.1016/j.bulcan.2019.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/22/2019] [Accepted: 08/29/2019] [Indexed: 01/08/2023]
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11
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Yoon EJ, Zhang J, Weinberg RS, Brochstein JA, Nandi V, Sachais BS, Shi PA. Validation of simple prediction algorithms to consistently achieve CD3+ and postselection CD34+ targets with leukapheresis. Transfusion 2019; 60:133-143. [PMID: 31756000 DOI: 10.1111/trf.15576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/21/2019] [Accepted: 09/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cellular therapies using engineered T cells, haploidentical transplants, and autologous gene therapy are increasing. Specified CD3+ or high CD34+ doses are typically required for subsequent manufacturing, manipulation, or CD34+ selection. Simple, practical, and reliable lymphocyte and hematopoietic progenitor cell (HPC) collection algorithms accounting for subsequent CD34+ selection have not been published. STUDY DESIGN AND METHODS In this analysis of 15 haploidentical donors undergoing tandem lymphocyte and HPC collections, we validated one-step, practical prediction algorithms (Appendix S1, available as supporting information in the online version of this paper) that use conservative facility-specific collection efficiencies, CD34+ selection efficiency, and donor-specific peripheral counts to reliably achieve the target CD3+ and CD34+ product doses. These algorithms expand on our previously published work regarding predictive HPC collection algorithms. RESULTS Ninety-three percent of lymphocyte and 93% of CD34+ collections achieved the final target CD3+ and CD34+ product dose when our algorithm-calculated process volumes were used. Linear regression analysis of our algorithms for CD3+, preselection CD34+, and postselection CD34+ showed statistically significant models with R2 of 0.80 (root mean square error [RMSE], 31.3), 0.72 (RMSE, 385.7), and 0.56 (RMSE, 326.0), respectively, all with p values less than 0.001. CONCLUSION Because achievement of CD3+ or CD34+ dose targets may be critical for safety and efficacy of cell therapies, these simple, practical, and reliable prediction algorithms for lymphocyte and HPC collections should be very useful for collection facilities.
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Affiliation(s)
- Edward J Yoon
- Clinical Services, New York Blood Center, New York, New York.,Temple University Hospital, Philadelphia, Pennsylvania
| | - Jiahao Zhang
- Clinical Services, New York Blood Center, New York, New York
| | - Rona S Weinberg
- Clinical Services, New York Blood Center, New York, New York.,Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York
| | - Joel A Brochstein
- Division of Pediatric Hematology-Oncology, Northwell Health, New Hyde Park, New York
| | - Vijay Nandi
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York
| | - Bruce S Sachais
- Clinical Services, New York Blood Center, New York, New York.,Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York
| | - Patricia A Shi
- Clinical Services, New York Blood Center, New York, New York.,Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York
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