Impact of custom prime on the PBSC collection efficiency and procedure outcome on Spectra Optia apheresis device by using the CMNC program in low-weight pediatric oncology patients. A single-center experience

Primed for change: The effect of a blood prime on peripheral blood stem cell collection and accuracy of a prediction tool in pediatric patients

“…They reported that the predictability of CD34 + cell yields is not optimal in smaller children. 11 Furthermore, they found that CE was inversely correlated with percentage of the patient's TBV in the extra-T A B L E 4 Correlation analysis comparing CD34 + cell yield for patients requiring a blood prime when predicted with our dilution adjusted formula compared to the NMDP predictor tool. corporeal circuit.…”

“…They reported a CE of 48% in the low blood volume (LBV; defined as <50% of TBV in ECV) and of 26% in the very low blood volume (VLBV; defined as >50% TBV in ECV) group. 11 They concluded that the predictive ability of Pierelli's formula could be improved by including the dilution effect of blood prime that negatively impacts CE but did not modify the equation. We can assume that the LBV and VLBV groups in Milojkovic et al study roughly correspond to our higher and lower weight groups, respectively.…”

“…10 A blood prime is used because the ECV blood in a low-weight pediatric patient can be up to 50% of the patient's TBV during continuous apheresis collection. 11 The need for a blood prime is to prevent significant hemodynamic changes due to the ECV of blood at any given time during apheresis collection. The blood prime does not contain CD34 + cells and creates a dilution effect which impacts the CE.…”

“…A recently published study reports a strong negative impact of blood prime on CE. 11 Because use of a blood prime during pediatric apheresis collections results in a dilutional effect of the peripheral blood CD34+ count and thus impact CE, we evaluated the relationship between pre-apheresis peripheral blood CD34 + counts and the final CD34 + apheresis yield.…”

“…Weight less than 25 kg is the cut off at which the patient's extracorporeal volume (ECV) during apheresis collection exceeds 10%‐15% of the total blood volume (TBV) 10 . A blood prime is used because the ECV blood in a low‐weight pediatric patient can be up to 50% of the patient's TBV during continuous apheresis collection 11 . The need for a blood prime is to prevent significant hemodynamic changes due to the ECV of blood at any given time during apheresis collection.…”