Comparison of prediction models for two different peripheral stem cell collection protocols in autologous patients. How to avoid errors in calculating total blood volume to process?

Abstract

Introduction: Calculating accurate blood volume to process is a critical practice in apheresis planning; therefore, researchers try to develop dedicated prediction models. In this analysis, we have attempted to compare three algorithms for two different apheresis collection protocols.Methods: In a retrospective study, we have analyzed 137 apheresis procedures performed on 100 autologous patients. Apheresis procedures were performed with the Spectra Optia apheresis device with two protocols: mononuclear cell collection (MNC) and continuous mononuclear cell collection (cMNC). Three algorithms: a model based on mean collection efficiency (CE2), a linear regression model, and a power regression model were validated by plotting collected CD34 + cell dose versus predicted CD34 + cell dose.Results: All models showed high predictability for MNC procedure, a high correlation of predicted CD34 + yield and actual CD34 + yield (R 2 =0.9547; 0.9487; 0.9474 for CE2-based model, linear and power regression model, respectively). In contrast, alteration between models for the cMNC procedure was greater (R 2 =0.8049, 0.7970, and 0.8169) with a higher number of overpredictions. Further analysis revealed that for low CD34 + precounts blood volume to process, calculated with the three models, differ significantly up to fivefold times.Conclusions: Utilizing regression models may lead to calculation errors, which can affect undercollection, repetition of apheresis, or even mobilization failure. Contrary to regression models, the model based on mean CE2 gave the most accurate prediction both for MNC and cMNC procedures. Although new prediction algorithms are created, this simple formula remains a reliable tool that promotes careful planning of apheresis, thus improving patient safety.

CD34+ cell yield among healthy donors: Large‐scale model development and validation

“…Accordingly, to optimize CD34+ cell collection, multiple centers have developed, validated, and implemented formulas that consider various factors influencing CD34+ cell yield. [15][16][17][18][19][20][21][22][23][24][25] Applying these predictive formulas in clinical settings outside of their originating centers can pose challenges due to limited sample size, which restricts the ability to observe variations and shifts in donor characteristics, apheresis procedure parameters, or operator performance. 26 In pursuit of a more universal model, we conducted a secondary analysis of data collected by the Center for International Blood and Marrow Transplant Research (CIBMTR).…”

“…To streamline this process and ensure cost‐effectiveness, accurate estimation of CD34+ cell yield is paramount. Accordingly, to optimize CD34+ cell collection, multiple centers have developed, validated, and implemented formulas that consider various factors influencing CD34+ cell yield 15‐25 . Applying these predictive formulas in clinical settings outside of their originating centers can pose challenges due to limited sample size, which restricts the ability to observe variations and shifts in donor characteristics, apheresis procedure parameters, or operator performance 26 …”

The efficiency of a continuous versus an intermittent apheresis method for collection of hematopoietic progenitor stem cells: A systematic review

“…The cells are collected after the hematopoietic stem cells have been mobilized out of the bone marrow into the blood stream either by using preconditioning chemotherapy and granulocyte‐ colony‐stimulating factor (G‐CSF) or G‐CSF alone. The methods used in the apheresis procedure comprise of two types: continuous and intermittent collection of CD34+ cells 11 . In the continuous collection method, the patient's blood is pumped through the machine, centrifuged, and returned simultaneously 12 with the CD34+ being continuously pumped into a collection bag.…”

“…The methods used in the apheresis procedure comprise of two types: continuous and intermittent collection of CD34+ cells. 11 In the continuous collection method, the patient's blood is pumped through the machine, centrifuged, and returned simultaneously 12 with the CD34+ being continuously pumped into a collection bag. The intermittent collection method is considered a discontinuous collection method, as it works in cycles.…”