Manual color monitoring to optimize hematopoietic progenitor cell collection on the Fenwal Amicus

Abstract

A technique was developed to improve consistency of MNC transfers from the centrifuge to the collection bag in the Fenwal Amicus. The operator assures that RBCs completely fill the cassette by the end of the transfer by adjusting the RBC offset in succeeding cycles. We compared yields and crosscellular content before and after implementation of the monitoring technique. Retrospective data from 400 consecutive HPC collection procedures (200 for each technique) were compared. In 40 monitored collections, the RBC offset was adjusted to 6-9 mL to ensure that RBCs completely filled the cassette. Collections requiring these adjustments were not associated with a specific diagnosis. Median values were compared between the 40 collections requiring offset adjustment and those performed before implementation of monitoring. Baseline peripheral CD34+ cell (17 vs. 14 cells μL(-1)), lymphocytes (2 vs. 1.3 × 10(9) /L), WBCs, HCT, and PLTs were significantly higher in the group requiring offset changes. The group requiring offset changes had significantly more CD34+ cells per collection (190.8 × 10(6) or 2.04 × 10(6) /kg vs. 84.3 × 10(6) or 0.89 × 10(6) /kg) and more lymphocytes per collection (16.9 × 10(9) vs. 11.6 × 10(9)). Crosscellular content of the group requiring offset changes was significantly higher for WBCs (41.8 vs. 33.1 × 10(9)), granulocytes (9.6 vs. 7.2 × 10(9)), RBCs (23 vs. 17 mL), and PLTs (2.1 vs. 1.2 × 10(11)). Manual monitoring is a simple, inexpensive method to optimize each HPC collection to maximize CD34+ cell and lymphocyte yields.

A prospective randomized trial of two popular mononuclear cell collection sets for autologous peripheral blood stem cell collection in multiple myeloma

“…G‐CSF may further increase plasma and whole blood viscosity due to increases in fibrinogen, Factor VIII and von Willebrand factor, PLT count, and PLT activation 64‐66 . In the Fenwal Amicus, high PLT counts and increased plasma viscosity are both theorized to interfere with cell collection, leading to decreased MNC‐CE, lower CD34/kg yields, and missed collection cycles 67 . Although we were unable to demonstrate a direct association between CD34 collection and paraprotein levels, it is noteworthy that only MM patients demonstrated a drop in the CD34 collection rate at high WBC counts.…”

First comparative evaluation of a new leukapheresis technology in non‐cytokine‐stimulated donors

“…In the Amicus system, the cell transport to the collection bag is started automatically after achieving the preset cycle volume as well. During the cell transfer, the MNC population within the extracted cell line is selected by measurement of light transmittance and the operator given MNC and RBC offset volumes . Hence, both the COM.TEC and Amicus devices employ a single chamber procedure, in which the MNC population is intermittently extracted from the separation chamber and the nature of its cells corresponds to the definite composition of the final product, while leukapheresis with the Spectra Optia is based on a simultaneous two‐stage processing.…”

Phase 2 trial of intravenously administered plerixafor for stem cell mobilization in patients with multiple myeloma following lenalidomide-based initial therapy

“…The collection method has previously been described. 27 In brief, patients underwent leukapheresis for five hours with patients with white blood cell counts of less than 35×10 9 /L processed at a blood flow rate of 90 ml/min utilizing a cycle volume of 1,400 ml and those with white blood cell counts greater than 35×10 9 /L processed at a blood flow rate of 65 ml/min utilizing a cycle volume of 1,000 ml. 28 Anticoagulant consisted of a mixture of ACD-A (Baxter Healthcare Corp., Deerfield, IL, USA), normal saline, and heparin.…”

“…MNC offset was 1.5 ml and RBC offset was 5 ml and adjusted during the procedure as necessary. 27 Patients began collection approximately 4 hours after the completion of the plerixafor infusion. Patients continued to receive daily G-CSF and IV plerixafor each morning of apheresis for a maximum of four doses or until collection goal met.…”