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Safety of large‐volume leukapheresis for collection of peripheral blood progenitor cells
Author(s) -
Reik Rita A.,
Noto Thomas A.,
Fernandez Hugo F.
Publication year - 1997
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(1997)12:1<10::aid-jca3>3.0.co;2-d
Subject(s) - medicine , leukapheresis , peripheral blood , apheresis , progenitor cell , intensive care medicine , immunology , stem cell , cd34 , platelet , genetics , biology
Large volume leukapheresis (LVL) reduces the number of procedures required to obtain adequate peripheral blood progenitor cells (PBPCs) for autologous hematopoietic reconstitution. LVL involves the processing of >15 L or 5 patient blood volumes using high flow rates. We report our experience with LVL evaluating its efficiency and adverse effects in 71 adult patients with hematologic or solid organ malignancies. All were mobilized with chemotherapy and granulocyte colony‐stimulating factor (G‐CSF). All collections used a double lumen apheresis catheter. Means values per LVL were as follows: blood processed, 24.6 L; patient blood volumes processed, 5.9; ACD‐A used. 1.048 ml; heparin used, 6,148 units; collect time, 290 min; blood flow rate, 89 ml/min. Eighty percent of the collections were completed in one or two procedures to obtain ≥6.0 × 10 8 MNCs/kg body weight. The most frequent side effect (39%) was parasthesia due to citrate‐related hypocalcemia. This was managed with oral calcium supplements and or slower flow rates. Post‐LVL electrolyte changes were generally asymptomatic. Prophylactic oral potassium supplements were administered in 57% of cases. Other reactions included hypotension (4%), prolonged parasthesia (1.4%), and headache (1.4%). Catheter problems in 9 (13%) of the procedures were attributed to clot formation (37%) or positional effects (63%). No bleeding occurred. Post‐LVL decreases in hematocrit and platelet count averaged 3.5% and 46%, respectively. Six (4%) of the procedures required red blood cell transfusions. Platelet transfusions were given in 19 (13%) of the procedures. We conclude that adverse reactions with LVL are similar to those reported for conventional PBPC collections, making it safe and efficacious as an outpatient procedure. J. Clin Apheresis 12:10–13, 1997. © 1997 Wiley‐Liss, Inc.