CD34+ progenitors and colony‐forming units‐granulocyte macrophage are recruited during large‐volume leukapheresis and concentrated by counterflow centrifugal elutriation

Abstract

The recruitment of mononuclear cells (MNCs), colony-forming units-granulocyte macrophage (CFU-GM), lymphocyte subpopulations, and CD34+ progenitor cells was studied during large-volume (15-25 L blood processed) peripheral blood stem cell (PBSC) harvests. Normal donors (n = 13) underwent a 4-hour leukapheresis designed to maximize PBSC yield (blood flow rate, 85 mL/min). Mean (+/- SD) volume processed was 17.7 +/- 0.4 L, and yield was 2.4 +/- 0.7 x 10(10) white cells containing 99 percent MNCs and 1.3 mL red cells per L of blood processed. Postapheresis hematocrit, platelets, and MNCs were reduced from preapheresis values by 7, 35, and 23 percent, respectively (p < 0.05). In nine donors, the component was collected as four 1-hour samples, and culturing of CFU-GM and flow cytometric analysis of lymphocyte subpopulations and CD34+/HLA-DR+ cells were done in individual samples. Total CFU-GM were 2.4 +/- 1.4 x 10(6) (3.0 +/- 1.8 x 10(4) CFU-GM/kg) and lymphocytes were 20.8 x 10(9), with 75 percent CD3+ T cells, 10 percent CD19/CD20+ B cells, and 17 percent natural killer cells. A more than twofold increase in CFU-GM and CD34+ cells was noted over the course of the 4-hour procedure (p < 0.05). In four donors, the leukapheresis component underwent counterflow centrifugal elutriation (CCE), which separated it into four fractions in an attempt to concentrate CD34+ and CFU-GM progenitors and to deplete T-lymphocytes on a large scale. There was a 1.8-, 4.6-, 3.9-, and 0.32-fold increase in CFU-GM in the four fractions relative to the unseparated component.(ABSTRACT TRUNCATED AT 250 WORDS)

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

“…The optimal study design would be to compare products collected during the same procedure at different time, which was done in this study, and differences caused by interindividual variability were excluded. Studies of kinetics of PBSC enrichment during LVL showed variable results [3,[8][9][10][19][20][21][22][23][24][25][26][27][28][29][30][31], which could be consequence of difference in volumes of processed blood. Therefore, processed blood volume in our study was standardized and strictly related to the patient's TBV.…”

Ancestim (recombinant human stem cell factor, SCF) in association with filgrastim does not enhance chemotherapy and/or growth factor-induced peripheral blood progenitor cell (PBPC) mobilization in patients with a prior insufficient PBPC collection

“…[7][8][9] To overcome the inconvenience and cost of multiple procedures, large volume leukaphereses (LVL), defined as the processing of more than three blood volumes (BVs) or 15 l of blood in a single session, have been used as a way of processing a high number of patients' BVs in a single session. [10][11][12][13][14] LVL can also recruit PBPC into the circulatory compartment, allowing the continuous harvest of large numbers of progenitors throughout the procedure. [10][11][12]14 Similar recruitment of PBPC has been reported by some 15 but not others 16 with standard volume leukapheresis (SVL).…”

“…[10][11][12]14 Similar recruitment of PBPC has been reported by some 15 but not others 16 with standard volume leukapheresis (SVL). The group in Lisboa 10 and others [11][12][13][14] have shown that LVL is safe and at least as efficient as SVL for PBPC harvesting, allowing the collection of an adequate PBPC product in the majority of cancer patients in a single session.…”

Kinetics of standardized large volume leukapheresis (LVL) in patients do not show a recruitment phenomenon of peripheral blood progenitor cells (PBPC)

“…7,8,[15][16][17][18][19][20] Therefore, the standardization of processed blood volumes seems to be necessary to enable a better interindividual comparison. 26,27 Moreover, animal studies showed distinct changes of G-CSF blood levels and suggest the G-CSF administration 2 h before the start of LVL.…”

“…A recruitment phenomenon (an above average increasing number of PBPC harvested during LVL and induced by the LVL) has been postulated in healthy donors and chemotherapymobilized patients. 7,8,15 The recruitment of stem cells has been described as a phenomenon, whereby the leukapheresis procedure itself exerts a stimulatory effect on the release of CD34 ϩ cells into the circulation. 16 Recent studies with slightly different regimens in adults gave controversial results.…”