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A new protocol for improving efficiency of autologous peripheral blood stem cell collection in patients with high white blood cell counts
Author(s) -
Boehlen Rahel,
Fernandez Paula,
Bargetzi Mario,
Sigle JoergPeter
Publication year - 2020
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.21782
Subject(s) - medicine , apheresis , cd34 , white blood cell , peripheral blood mononuclear cell , blood cell , peripheral blood , stem cell , surgery , gastroenterology , platelet , biology , in vitro , genetics , biochemistry , chemistry
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.