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Peripheral blood stem cell collection in multiple myeloma: A retrospective analysis of 6 years leukapheresis activity in 109 patients treated at the Istituto Nazionale dei Tumori of Milan
Author(s) -
Coluccia Paola,
Montefusco Vittorio,
Tunesi Sara,
Avella Mario,
Bompadre Alvaro,
Longoni Paolo,
Milanesi Marco,
De Carli Adriano,
Ravagnani Fernando
Publication year - 2009
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/jca.20203
Subject(s) - leukapheresis , medicine , multiple myeloma , platelet , cd34 , apheresis , urology , nuclear medicine , surgery , gastroenterology , stem cell , immunology , andrology , biology , genetics
Double autologous stem cell transplantation is the standard treatment in newly diagnosed multiple myeloma (MM) patients younger than 65 years; therefore, optimization of leukapheresis is crucial. We performed a retrospective analysis of 297 leukaphereses comparing semiautomated (V4.7 in 20% of collections) versus automated (V6.0 in 80%) Caridian (COBE) Spectra versions and analyzing the influence of M‐protein on the outcome. Both methods gave comparable collection efficiencies (CE%) (53.4% vs. 55.7% in V6.0 and V4.7, respectively) with similar leukapheresis time and processed volume. Harvest volume was higher in V4.7 ( P < 0.0001) with similar contamination of red blood cells (RBCs) ( P = 0.77) and platelets ( P = 0.09) when compared with V6.0. In patients with higher peripheral white blood cells (WBCs), V6.0 with adjusted harvest volume (<700 mL), achieved similar CD34 + CE% ( P = 0.39) and better enrichment of nucleated cells ( P < 0.0,002) but higher RBCs ( P < 0.0,001) and platelets contamination ( P = 0.001), when compared with a larger cycle volume in patients with lower WBCs. In hard to mobilize patients, CD34 + CE% was significantly more efficient with V4.7 than V6.0 ( P < 0.0,001). CD34 + CE% was unaffected by serologic M‐protein, but platelet CE% was higher in the absence of M‐protein ( P = 0.0,003), without any reduction in peripheral patients platelets. We, therefore, conclude that in the setting of MM patients with a high WBCs count and/or low percentage of peripheral CD34 + cells, collections with V4.7 or adjusted cycle volume V6.0 gave comparable result in CD34 + CE%. RBCs and platelets contamination is higher if low cycle volume is chosen. In hard to mobilize patients, V4.7 is advisable. J. Clin. Apheresis, 2009. © 2009 Wiley‐Liss, Inc.