Standard and large volume leukapheresis of peripheral blood progenitor cells using the new Spectra Optia continuous mononuclear cell collection protocol
Authors:
Z. Gašová 1,2; B. Vacková 3; Z. Bhuiyan-Ludvíková 1; M. Böhmová 1; M. Slouková 1; I. Marinov 4; P. Pecherková 1
Authors‘ workplace:
Ústav hematologie a krevní transfuze, Praha
1; Ústav klinické a experimentální hematologie, Praha
2; I. interní klinika – klinika hematologie, Všeobecná fakultní nemocnice a 1. LF UK, Praha
3; Ústav hematologie a krevní transfuze, Laboratoř průtokové cytometrie, Praha
4
Published in:
Transfuze Hematol. dnes,23, 2017, No. Supplementum1, p. 94-104.
Category:
Overview
Background:
The aim of the study was to evaluate and optimize the new protocol for continuous mononuclear cell collection (CMNC) Spectra Optia v. 11 (Terumo) which was used for PBPC collections in patients with haemato-oncological diseases. The results of 159 autologous PBPC collections were evaluated in the case of: (a) well mobilized patients with pre-collection CD 34+ cell concentration in blood higher than 20/μl, (b) only the first collections performed either using CMNC Spectra Optia v. 11 or Cobe Spectra v. 6, v. 7, Terumo (c) collections were performed in the Standard and Large volume Leukapheresis regimen, LVL. Engraftment data from 56 transplanted patients were assessed.
Results:
Standard collections were performed in 52 patients. The yield of CD 34+ cells was high, and no significant differences were found between the numbers of CD 34+ cells prepared using Spectra Optia 8.6 (1.3–41) × 106 and Cobe Spectra 10.9 (1.8–45.6) × 106 /kg b. w. (a = 0.05; p = 0.619). The dependence of CD 34+ cell yield on the pre-collection concentration of CD 34+ cells in blood can be considered as linear with high correlation coefficients in CMNC Spectra Optia R = 0.95, and Cobe Spectra R = 0.93.
LVL collections were performed in 107 patients and there were no significant differences between the numbers of CD 34+ cells prepared using CMNC Spectra Optia 10.9 (2-61.2)× 106 and Cobe Spectra 9.3 (2.4-86) × 106 /kg b.w. (a = 0.05; p = 0.35). The relationship between the pre-collection CD 34+ cell concentration in blood and the numbers of CD 34+ cells collected could also be considered as linear with the correlation coefficients in CMNC Spectra Optia R = 0.93, and Cobe Spectra R = 0.78, respectively. In LVL, the median platelet loss was significantly lower in CMNC Spectra Optia (45%) than in Cobe Spectra (57%). Twelve patients were transplanted using PBPC prepared in the standard regimen and 44 using PBPC from LVL. Median time to neutrophil reconstitution in the standard regimen was 11 days for both CMNC Spectra Optia and Cobe Spectra, while platelet reconstitution was 14 days for CMNC and 12 days for Cobe Spectra. The median time to neutrophil and platelets reconstitution in LVL was the same for CMNC Spectra Optia and, corresponding to 11 and 13 days, respectively.
Conclusions:
The CMNC Spectra Optia protocol is a modern, efficient and safe system that can be used for both Standard and LVL procedures. In well mobilized patients, a sufficient dose of CD 34+ cells for transplantation could be prepared from one Standard or one LVL procedure. No serious adverse reactions have been observed.
KEY WORDS:
PBPC – autologous PBPC transplantation – CD 34+ cells – standard and large volume leukapheresis (LVL) – Optia CMNC
Sources
1. Brecher ME, Lasky LC, Sacher RA, Issit LA. Hematopoietic progenitor cells: processing, standards and practice. In AABB, Technical Manual, Bethesda MD: 1995:68–86.
2. Roberts GT, Sacher RA. Impact of cell culture technology on transfusion medicine. In: Smit-Sibinga CTh, Das PC, Briet E, editors. Hereditary diseases and blood transfusion. Proceedings of the Nineteenth International Symposium on Blood Transfusion, Groningen, 1994: 153–164.
3. Lasky LC, Warkentin PI. Marrow and Stem cell Processing for transplantation. In Brecher M. E., Lasky L.C., Sacher R. A, Issit L. A. (ed.): Hematopoietic progenitor cells: processing, standards and practice, AABB Technical Manual, Bethesda, Maryland, 1995. p. 1–33.
4. Dregger P, Schmitz N. Allogeneic transplantation of hematopoietic stem cells: blood versus bone marrow. In Rowe JM, Lazarus HM, Carella AM, editors. Handbook of Bone Marrow Transplantation, UK, M. Dunitz, 2000:183–201.
5. Moller AKH et al. Recruitment of CD 34+ cells during large volume leukapheresis. J Haematother Stem Cell Res 2001;10:837–853.
6. Burgstaler EA. Current instrumentation for apheresis; In: McLeod B. Apheresis: principles and practice. Bethesda MD: AABB Press, 2010; 71–85; Schwartz J, Padmanabhan A, Francis RO et al. HPC collection by apheresis. In: McLeod B. Apheresis: principles and practice. Bethesda MD: AABB, 2010; 494–496.
7. Comenzo RL, Vosburgh E, Weintraub LR, Tansan S, Arkin CF, Wright DG. Collection of mobilized blood progenitor cells for hematopoietic rescue by large volume leukapheresis. Transfusion 1995;35(6):494–497.
8. Gašová Z, Marinov I, Hrubá A, Benešová K, Turek P. The efficiency of PBPC collections and the relationship to the precollection concentration of CD 34+ cells in blood. Transf Sci 1999;20(3):181–188.
9. Gašová Z, Lerlova A, Vodvarkova S, Marinov I, Böhmova M, Bhuiyan-Ludvikova Z. The dependence of the yield of CD 34+ cells on the precollection and run parameters using the standard and large volume leukapheresis (LVL) in donors and in patients. Transf Sci 2005;32:167–176.
10. Lane T. Mobilization of hematopoietic progenitor cells. In Brecher M. E., Lasky L.C., Sacher R. A, Issit L. A. (ed.): Hematopoietic progenitor cells: processing, standards and practice. AABB Technical Manual, Bethesda, Maryland, 1995. p. 68–86, 125, 132–134.
11. Smolowicz AG. LVL apheresis for the harvest of peripheral blood progenitor cells for autologous transplantation. Transfusion 1996;37:160–167.
12. Sanderson F, Poullin P, Smith R, Nicolino-Brunet C, Philip P, Chaib A, Costello R. Peripheral blood stem cells on Spectra Optia apheresis system using the continuous mononuclear cell collection protocol: A single center report of 39 procedures. J Clin Apher 2017;32(3):182–190.
13. Gašová Z, Bhuiyan-Ludvíková Z, Böhmová M, et al. PBPC collections: management, techniques and risks. Transf Apher Sci 2010;43:237–243.
14. Lee JL, Kim S-B, Lee G-W, et al. Collection of peripheral blood progenitor cells: analysis of factors predicting the yields. Transf Apher Sci 2003;29:29–37.
15. Weinstein R. Prevention of citrate reactions during therapeutic plasma exchange by constant infusion of calcium gluconate with the return fluid. J Clin Apher 1996;11:204–210.
16. Kankirawatana S, Huang ST, Maerques MB. Continuous infusion of calcium gluconate in 5% albumin is safe and prevents most hypocalcemic reactions during therapeutic plasma exchange. J Clin Apher 2007;22:265–269.
Labels
Haematology Internal medicine Clinical oncologyArticle was published in
Transfusion and Haematology Today
2017 Issue Supplementum1
Most read in this issue
- Dysfibrinogenaemia and afibrinogenaemia in the Czech Republic
- Centre for rare disorders of haematopoiesis at the Institute of Haematology and Blood Transfusion
- Transfusion and immunohematology at the Institute of Haematology and Blood Transfusion
- Functional consequences of mutations in the nucleophosmin gene in acute myeloid leukaemia