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Successful collection and transplantation of peripheral blood stem cells in cancer patients using large‐volume leukaphereses
Author(s) -
Murea Simona,
Goldschmidt Hartmut,
Hahn Uwe,
Pförsich Margit,
Moos Marion,
Haas Rainer
Publication year - 1996
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/(sici)1098-1101(1996)11:4<185::aid-jca3>3.0.co;2-7
Subject(s) - medicine , peripheral blood stem cells , peripheral blood , transplantation , cancer , leukapheresis , peripheral , stem cell , pathology , oncology , surgery , immunology , hematopoietic stem cell transplantation , biology , genetics , cd34
It was the aim of our study to determine the collection efficiency and yield of CD34+ cells in 88 cancer patients (pts, 44 males/44 females) who underwent 154 large‐volume leukaphereses (LV‐LPs). The diagnoses were as follows: 18 patients had Non‐Hodgkin's lymphoma, 9 Hodgkin's disease, 24 multiple myeloma, 6 acute leukemia, 27 breast cancer, and 4 patients had solid tumors of different types. During the course of LV‐LPs, 20 liters (l) of blood were processed at a median flow‐rate of 85 ml/min (CS 3000 Baxter) and 130 ml/min (COBE Spectra), respectively. Peripheral blood stem cells (PBSC) were collected following granulocyte colony‐stimulating factor (G‐CSF)‐supported cytotoxic chemotherapy. A 31% and 21% mean decrease in the platelet and white blood count was noted at the end of the LV‐LPs when compared with the pre‐leukapheresis values. The aphereses were well tolerated without adverse effects. The level of circulating CD34+ cells was closely related to the number of CD34+ cells contained in the respective leukapheresis product (R = 0.89, P < 0.001). Compared with 270 patients who underwent 838 regular 101 LPs, the yield of CD34+ cells/kg was almost two‐fold greater (4.84 ± 0.63 × 10 6 [Mean ± SEM] vs 2.60 ± 0.16 × 10 6 , P < 0.001). The antigenic profile of CD34+ cells was assessed in 54 separate products collected on the occasion of 27 LV‐LPs following the processing of 101 and 201, respectively. The intra‐individual comparison included differentiation as well as lineage‐associated markers (CD38, Thy‐1, c‐kit, CD33, CD45RA). No difference in the subset composition was observed between the first and second product, arguing against a preferential release of particular CD34+ cell subsets during the procedure. As shown by molecular biological or immunocytochemical examination, the likelihood of harvesting malignant cells using large‐volume aphereses was not increased in comparison with regular leukaphereses. Single harvests of ≥2.5 × 10 6 CD34+ cells/kg could be obtained in 74% of the patients, compared with 52% in case of regular LPs. As the majority of patients were autografted with more than 2.5 × 10 6 CD34+ cells/kg following high‐dose therapy, hematological recovery in general was rapid and not related to the type of apheresis product used. Considering patient comfort and savings in resource utilization, large‐volume leukaphereses have become the standard procedure for PBSC collection in our center. © 1996 Wiley‐Liss, Inc.