Document Detail


Progenitor cell recruitment during individualized high-flow, very-large-volume apheresis for autologous transplantation improves collection efficiency.
MedLine Citation:
PMID:  16934079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Individual adaptation of processed patient's blood volume (PBV) should reduce number and/or duration of autologous peripheral blood progenitor cell (PBPC) collections. STUDY DESIGN AND METHODS: The durations of leukapheresis procedures were adapted by means of an interim analysis of harvested CD34+ cells to obtain the intended yield of CD34+ within as few and/or short as possible leukapheresis procedures. Absolute efficiency (AE; CD34+/kg body weight) and relative efficiency (RE; total CD34+ yield of single apheresis/total number of preapheresis CD34+) were calculated, assuming an intraapheresis recruitment if RE was greater than 1, and a yield prediction models for adults was generated. RESULTS: A total of 196 adults required a total of 266 PBPC collections. The median AE was 7.99 x 10(6), and the median RE was 1.76. The prediction model for AE showed a satisfactory predictive value for preapheresis CD34+ only. The prediction model for RE also showed a low predictive value (R2 = 0.36). Twenty-eight children underwent 44 PBPC collections. The median AE was 12.13 x 10(6), and the median RE was 1.62. Major complications comprised bleeding episodes related to central venous catheters (n = 4) and severe thrombocytopenia of less than 10 x 10(9) per L (n = 16). CONCLUSION: A CD34+ interim analysis is a suitable tool for individual adaptation of the duration of leukapheresis. During leukapheresis, a substantial recruitment of CD34+ was observed, resulting in a RE of greater than 1 in more than 75 percent of patients. The upper limit of processed PBV showing an intraapheresis CD34+ recruitment is higher than in a standard large-volume leukapheresis. Therefore, a reduction of individually needed PBPC collections by means of a further escalation of the processed PBV seems possible.
Authors:
Stefano Fontana; Rachel Groebli; Kurt Leibundgut; Thomas Pabst; Caroline Zwicky; Behrouz Mansouri Taleghani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  46     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-28     Completed Date:  2006-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1408-16     Citation Subset:  IM    
Affiliation:
Department of Hematology and Central Hematology Laboratory, Inselspital, University Hospital, Bern, Switzerland. stefano.fontana@insel.ch
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antigens, CD34
Catheters, Indwelling / adverse effects
Child
Child, Preschool
Hematopoietic Stem Cell Mobilization* / adverse effects
Hemorrhage / etiology
Humans
Infant
Leukapheresis*
Male
Middle Aged
Models, Biological*
Peripheral Blood Stem Cell Transplantation* / adverse effects
Predictive Value of Tests
Prospective Studies
Retrospective Studies
Thrombocytopenia / etiology
Transplantation, Autologous
Chemical
Reg. No./Substance:
0/Antigens, CD34

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