Cobe Spectra is superior to Fenwal CS 3000 Plus for collection of hematopoietic stem cells

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Summary:A total of 415 leukaphereses in 201 patients stimulated with growth factor (GF; n ¼ 119) or chemotherapy-GF (n ¼ 296) were studied to determine CD34 þ cell collection efficiency (CE). The pre-apheresis leukocyte count was 1-93 Â 10 9 /l (median 20), and peripheral blood CD34 count (PBCD34) was 1-1104/ll (median 19). The total number of CD34 þ cells collected was 4-6531 Â 10 6 (median 151); corresponding to 0.1-111.4 Â 10 6 (median 2.3) per kg. There was strong correlation between PBCD34 and the number of CD34 þ cells collected (r ¼ 0.9; Po0.0001). CE was 7-145% (median 46). On multiple regression analysis, a higher leukocyte count (Po0.0001) was the most important predictor of lower CE. CE with leukocytes o20 was 7-145% (median 53%) compared to 10-132% (median 40%) with leukocyte X20 (Po0.0001). In all, 61% of the apheresis procedures performed after chemotherapy-GF occurred when leukocytes were o20 compared to 21% of those performed after GF alone (Po0.0001). We conclude that mobilizing patients with the combination of chemotherapy and GF rather than GF alone leads to leukapheresis being performed when the leukocyte count is low -in a range that results in optimum CD34 þ cell CE. Autologous stem cells should be mobilized with chemotherapy-GF rather than GF alone whenever possible. Bone Marrow Transplantation (2005) 35, 243-246.

Section: Tablementioning

confidence: 99%

Can the stem cell mobilization technique influence CD34+ cell collection efficiency of leukapheresis procedures in patients with hematologic malignancies?

Gidron

Verma

Doyle

et al. 2004

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“…Stem cells were collected using the Fenwal CS 3000 Plus cell separator (Baxter, Deerfield, IL USA) or the Cobe Spectra cell separator (Gambro BCT, Lakewood, CO, USA) 11,12 after mobilization with filgrastim alone at a dose of 5-10 mg/kg daily; with apheresis commencing on the fourth or fifth day of G-CSF therapy.…”

Section: Methodsmentioning

confidence: 99%

Ideal or actual body weight to calculate CD34+ cell doses for allogeneic hematopoietic stem cell transplantation?

Cilley

Rihn

Monreal

et al. 2003

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Summary:The number of CD34 þ cells infused influences hematologic recovery after transplantation. Limited data suggest that cell dose should be based on ideal (IBW) rather than actual (ABW) body weight for autotransplantation, but none in allografts. We compared the correlation between recovery to 0.5 Â 10 9 /l neutrophils and the CD34 þ cell dose based upon ABW and IBW in 78 allograft recipients. ABW was X25% over IBW in 47% of patients. The median CD34 þ cell dose was 5.1 Â 10 6 /kg IBW and 4.4 Â 10 6 /kg ABW. The time to neutrophil recovery was 8-26 days (median 12). There was a stronger inverse correlation between CD34 þ cell dose/IBW and neutrophil recovery (r 2 ¼ 0.160; Po0.0001) than between CD34 þ cell dose/ABW and neutrophil recovery (r 2 ¼ 0.138; P ¼ 0.001). When neutrophil recovery in patients receiving o3 or o5 Â 10 6 CD34 þ cells/kg was compared to those receiving X3 or X5 Â 10 6 CD34 þ cells/kg, respectively, separately by IBW and ABW, the magnitude and significance of the differences were greater for IBW-based comparisons. These data suggest the CD34 þ cell dose based on IBW is a better predictor of neutrophil recovery after allografting. Further work in a larger, more homogeneous group of patients is required to confirm this observation.

“…[1][2][3][4] PBCD34 reflects the extent of mobilization of stem cells from the bone marrow into the blood-and depends upon a number of factors including diagnosis, extent of prior therapy, mobilization technique and type and dose of the growth factor used. 3,[5][6][7][8][9] However, PBCD34 is not always immediately available at the planned time of apheresis.…”

Section: Introductionmentioning

confidence: 99%

Correlation between serum lactate dehydrogenase and stem cell mobilization

Egan

Singh

Gidron

et al. 2007

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After observing a correlation between elevated serum lactate dehydrogenase (LDH) levels and good stem cell collections, retrospective data from 540 donors undergoing 650 stem cell apheresis procedures (87% autologous, 13% allogeneic) were studied to determine the correlation between preapheresis LDH levels and the absolute peripheral blood CD34 þ cell count (PBCD34). PBCD34 (1-1611/ll; median 40) correlated modestly with leukocytes (0.5-118.2 Â 10 9 /l; median 30.2) (r ¼ 0.16; P ¼ 0.00005) and poorly with platelets (16-660 Â 10 9 /l; median 131) (r ¼ 0.02; P ¼ 0.69). The correlation between LDH (64-1664 IU/l; median 310) and PBCD34 was very strong (r ¼ 0.54; Po10 À48 ). In multivariate regression analysis, serum LDH was the only factor correlating significantly with PBCD34. The correlation between serum LDH and PBCD34 was strong on the first day of collection (n ¼ 517; r ¼ 0.53; Po10 À37 ), weakened on the second day (n ¼ 74; r ¼ 0.37; P ¼ 0.0009) and disappeared beyond day 2 (n ¼ 59; r ¼ 0.09; P ¼ 0.49). PBCD34 was significantly higher (median 53 versus median 11; Po0.00001) when LDH was elevated (n ¼ 511) compared to when LDH was normal (n ¼ 139). The relationship between serum LDH and PBCD34 was strong for autologous (r ¼ 0.54) as well as for allogeneic (r ¼ 0.41) collections. Our data suggest that it is reasonable to assume good stem cell mobilization and start apheresis if the LDH is elevated.