Performance of a new separator system for routine autologous hematopoietic progenitor cell collection in small children

Abstract

The AMICUS system was recently introduced for peripheral blood stem cell (PBSC) aphereses in adults. We conducted a single center field evaluation to obtain data about the performance of this system in children with a body weight (bw) < 25 kg. Results of blood priming procedures were compared to historical data obtained with the Fenwal CS3000+ (CS 3000). From August, 2001 to February, 2007, 47/178 (26%) PBSC aphereses procedures were performed in our institution with the AMICUS system in 35 small patients (median bw 13.9 kg; range 6.7-24; age 2.78 years; range 0.97-7.06). The patients suffered from various malignant primary diseases or recurrences. We primed the system with packed RBC in case of >30% dilution of the RBC volume (n = 31) or with saline (n = 16). Compared to the CS3000, the AMICUS revealed comparable collection efficiencies (CE) for CD34+ cells (median 67%, range 26-120), lymphocytes (75%, 25-138), monocytes (54%, 23-173), and granulocytes (10%, 1.5-36), MNC (57% 24-125), but a significantly higher erythrocyte and granulocyte, and a lower platelet CE. There was a significant negative correlation between total leukocyte count and CE for MNC (r = -0.566; P < 0.001) and CD34+ cells (r = -0.517; P < 0.001). There was no significant statistical or clinical difference between the CE in blood-primed procedures and saline-primed procedures. With the AMICUS we saw statistically less citrate reactions compared to the CS 3000. We conclude that the AMICUS system is safe and efficient to harvest PBSC on a routine basis in pediatric patients, even in children < or =10 kg bw.

Use of various offset settings in the Fenwal Amicus during hematopoietic progenitor cell collection to increase lymphocyte yield and reduce cross‐cellular contamination

“…Comparing our results to those reported by others using the Amicus [5,[16][17][18][19] is difficult for several reasons. First, all of the references cited used chemotherapy and G-CSF for mobilization while we used only G-CSF.…”

“…The references that reported Amicus results used RBC offset settings of 6.0-7.5 mL [5,[16][17][18][19]. Witt et al described pediatric collections with the Amicus using offsets of 2.3/6.0 to 7.5 [16].…”

“…Witt et al described pediatric collections with the Amicus using offsets of 2.3/6.0 to 7.5 [16]. They reported lymphocyte collection efficiencies (CE) of 75% and good correlation between the lymphocyte CE and lymphocyte subpopulations (CD31 r 5 0.84, NK cells r 5 0.52, Spearman rank correlation coefficient, P < 0.001) [16].…”

“…Witt et al described pediatric collections with the Amicus using offsets of 2.3/6.0 to 7.5 [16]. They reported lymphocyte collection efficiencies (CE) of 75% and good correlation between the lymphocyte CE and lymphocyte subpopulations (CD31 r 5 0.84, NK cells r 5 0.52, Spearman rank correlation coefficient, P < 0.001) [16]. Snyder et al reported on mononuclear cell collections from nonmobilized donors using the Amicus (RBC offset 6.2-6.5) with lymphocyte CE of 68 AE 11% and NK cell CE of 55 AE 13% [20].…”

CD34+ collection efficiency as a function of blood volumes processed in pediatric autologous peripheral blood stem cell collection

“…These studies varied in using different cell separators and programs and mobilization regimens. Reported pediatric collection efficiencies for leukapheresis range from 33% to 67% [12][13][14][15][16]. Adult efficiencies have been reported to have a broader range: from 38% to 91% [17,18].…”