A new protocol for improving efficiency of autologous peripheral blood stem cell collection in patients with high white blood cell counts. Issue 3 (18th April 2020)

• Record Type: Journal Article
• Authors: Boehlen, Rahel; Fernandez, Paula; Bargetzi, Mario; Sigle, Joerg‐Peter
• Is Part Of: Journal of clinical apheresis. Volume 35:Issue 3(2020)
• Page Start: 217
• Page End: 223
• Publication Date: 2020-04-18
• Subjects: high WBC counts -- improved collection efficiency -- PBSC collection; Hemapheresis -- Periodicals; Blood -- Transfusion -- Periodicals; Blood -- Transfusion, Autologous -- Periodicals; Cell separation -- Periodicals; Leukapheresis -- Periodicals; Plasmapheresis -- Periodicals; 615.39
• DOI: 10.1002/jca.21782
• Languages: English
• ISSNs: 0733-2459

Abstract

Abstract: Background: Collection efficiency (CE) of peripheral blood stem cell (PBSC) collections is negatively affected by increasing white blood cell (WBC) counts of the patient. This study compared a new optimized mononuclear cell (MNC) collection protocol (OPP) to the standard MNC collection protocol recommended by the manufacturer (STP) for PBSC collection in patients with WBC counts >35 000/μL. Study design and methods: Single‐center, retrospective, and observational study of 81 autologous PBSC collections on Fenwal Amicus cell separators in 70 adult patients. Results: Median peripheral WBC count (×10 3 /μL; 44.2 in OPP group vs 46.5 in STP group) and median CD34 + count (105/μL in OPP group vs 40/μL in STP group) at the beginning of PBSC collection did not differ significantly. Median CE2 (45% vs 31%; P < .001) as well as CD34 + yield of the apheresis product both with regards to median absolute CD34 + content (×10 6 ; 793 vs 188; P = .001) as well as median CD34 + content (×10 6 )/kg body weight (8.93 vs 2.51; P = .002) were significantly higher for the OPP. Overall, 18/21 (86%) patients with the OPP obtained their target CD34 + amount with a single apheresis session, compared to 25/50 (50%) with the STP ( P = .005). PBSC collections using OPP lasted significantly longer (median 377 minutes vs 260 minutes; P < .001) than with the STP. Conclusions: The OPP significantly improves CE2 for PBSC collections on Fenwal Amicus cell separators in patients with pre‐apheresis WBC counts >35 000/μL and significantly reduces the necessity for multiple apheresis sessions. The OPP is therefore suited to reduce both patient burden and cost in autologous PBSC collection.