Successful granulocyte apheresis using medium molecular weight hydroxyethyl starch

Nanya, Mai; Yurugi, Kimiko; Kato, Ikunoshin; Hiramatsu, Hidefumi; Kawabata, Hiroshi; Kondo, Tadakazu; Iemura, Tomoki; Hishida, Rie; Shibutani, Erika; Matsui, Kazuaki; Nakagawa, Yoko; Niwa, Norimi; Kasai, Yasunari; Roig, Joseph; Arai, Yasuyuki; Miura, Yasuo; Maekawa, Taira; Hirai, Hideyo

doi:10.1007/s12185-019-02755-2

Cited by 11 publications

(8 citation statements)

References 27 publications

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“…The number of granulocytes collected in our study was comparable to those collected in studies in which GC was carried out without HES but lower than those seen in previously reported studies involving the use of HES [21,28,33,34]. Recently, HES of medium molecular weight was reported to be a safe and effective alternative to HES for granulocyte apheresis [35]. Alternative erythrocyte sedimentation agents may be an option in countries where HES is unavailable.…”

Section: Discussionsupporting

confidence: 65%

Comparison of two apheresis systems for granulocyte collection without hydroxyethyl starch

Hosoi,

Nakajima,

Tsujimoto

et al. 2023

Vox Sanguinis

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Background and ObjectivesGranulocyte transfusion (GTX) is a treatment option for severe infections in patients with neutropenia. In previous studies, hydroxyethyl starch (HES) was used to enhance red blood cell sedimentation for granulocyte collection (GC). However, there are safety concerns about HES, and HES is not readily available in some countries. Therefore, we compared the granulocyte counts and GC efficiency achieved by two apheresis systems without HES.Materials and MethodsAll consecutive GC procedures performed between July 2011 and March 2018 at our hospital were analysed. COBE Spectra was used until 5 February 2016, and Spectra Optia was used afterwards. HES was not used.ResultsTwenty‐six GC procedures were performed, including 18 performed using COBE Spectra and 8 using Spectra Optia. When Spectra Optia was used, >1 × 1010 neutrophils were collected from seven of the eight (88%) procedures. Although there was no significant difference in the granulocyte yield between COBE Spectra‐based and Spectra Optia‐based GC procedures, the collection efficiency of Spectra Optia was significantly higher than that of COBE Spectra (p = 0.021). Furthermore, the granulocyte yields of Spectra Optia‐based GC tended to be more strongly correlated with the peripheral blood neutrophil count on the day of apheresis than those of COBE Spectra‐based GC.ConclusionOur results suggest that Spectra Optia achieves greater GC efficiency than COBE Spectra, even without HES. GTX may be a therapeutic option for severe neutropenia, even in places where HES is not available.

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Section: Discussionsupporting

confidence: 65%

Comparison of two apheresis systems for granulocyte collection without hydroxyethyl starch

Hosoi,

Nakajima,

Tsujimoto

et al. 2023

Vox Sanguinis

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“…For donor safety, it might be crucial to minimize the processing time and PBV. In contrast, the granulocyte CE in the m0.8 group was similar to the hHES group and was not inferior to other reports with HES130/0.4 12,13 . Although there was no significant difference, the CE tended to be highest with the m0.44 method, with the slowest flow rates of 40 mL/min among m0.46, m0.44, and m0.37.…”

Section: Discussionsupporting

confidence: 46%

“…The development of hematological abnormalities and diffused tissue storage has been reported in patients with renal failure who had excessive HES exposure 11 . Recent reports demonstrated that sufficient granulocytes could be harvested via apheresis using a medium molecular weight HES (mHES) (HES130/0.4: Voluven®; Otsuka Pharmaceutical Factory, Inc., Tokushima, Japan) 12–14 . HES130/0.4 is a third‐generation HES characterized by an average molecular weight of 130,000 Dalton and a molar substitution of 0.4.…”

Section: Introductionmentioning

confidence: 99%

Efficient granulocyte collection method using high concentrations of medium molecular weight hydroxyethyl starch

Kondo

Fujii

et al. 2023

Transfusion

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Background Granulocyte transfusion therapy is a rational therapeutic option for patients with prolonged, severe neutropenia. Although high molecular weight hydroxyethyl starch (hHES) facilitates the separation of red blood cells during granulocyte collection, renal dysfunction has been noted as a potential side effect. HES130/0.4 (Voluven®) is a medium molecular weight HES (mHES) with superior safety profiles compared to hHES. Although HES130/0.4 is reportedly effective in the collection of granulocytes, we lack studies comparing the efficiency of granulocyte collection using HES130/0.4 and hHES. Study Design and Methods We retrospectively collected the data from 60 consecutive apheresis procedures performed on 40 healthy donors at the Okayama University Hospital between July 2013 and December 2021. All procedures were performed using the Spectra Optia system. Based on the HES130/0.4 concentration in the separation chamber, granulocyte collection methods using HES130/0.4 were classified into m0.46, m0.44, m0.37, and m0.8 groups. We used HES130/0.4 and hHES groups to compare the various sample collection methods. Results The median granulocyte collection efficiency (CE) was approximately 24.0% and 28.1% in the m0.8 and hHES groups, respectively, which were significantly higher than those in the m0.46, m0.44, and m0.37 groups. One month following granulocyte collection with HES130/0.4, no significant changes were observed in serum creatinine levels compared to those before the donation. Conclusion Therefore, we propose a granulocyte collection approach employing HES130/0.4, which is comparable to the use of hHES in terms of the granulocyte CE. A high concentration of HES130/0.4 in the separation chamber was considered crucial for granulocyte collection.

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“…Several other studies have explored other RBC‐sedimenting agents apart from high‐molecular‐weight HES, which has been the standard and was used in the current study. Recently, Nannya et al reported the efficacy of 130 kDa HES, which is categorised as low‐ to medium‐molecular‐weight HES, in granulocyte collections from seven donors 23 . They performed granulocyte apheresis for two consecutive days using Spectra Optia; the CE2 on days 1 and 2 of apheresis was reported to be 14.5% ± 2.8% and 13.7% ± 2.8%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Impact of the use of hydroxyethyl starch in granulocyte apheresis using Spectra Optia

Yoshihara

Ikemoto

Onomoto

et al. 2021

Transfusion Medicine

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Objectives To determine the impact of the use of hydroxyethyl starch (HES) in granulocyte apheresis using Spectra Optia. Background Granulocyte transfusion (GT) is a therapeutic option for neutropenic patients with severe bacterial or fungal infections. Recent studies in emergency medicine have shown the potential risk of using HES, which is routinely used in granulocyte apheresis to increase yield by sedimenting red blood cells. We hypothesized that the use of a newer device (Spectra Optia) would spare the need for HES. Methods We retrospectively compared granulocyte apheresis with HES (HES group, n = 89) and without HES (non‐HES group, n = 36) using Spectra Optia. Results The granulocyte yield was significantly higher in the HES group (7.3 × 1010 vs. 2.0 × 10, p < 0.01) and was attributed to the difference in collection efficiency (36% vs. 7.7%, p < 0.01). The absolute neutrophil count on the following morning of GT was significantly higher in the HES group than in the non‐HES group (2460/μl vs. 505/μl, p < 0.01). There were no significant differences in the occurrence of adverse events between the HES and non‐HES groups. The renal function was unchanged in both groups after apheresis. Conclusions We demonstrated that the advantage of using HES remained unchanged in granulocyte apheresis using Spectra Optia.

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Successful granulocyte apheresis using medium molecular weight hydroxyethyl starch

Cited by 11 publications

References 27 publications

Comparison of two apheresis systems for granulocyte collection without hydroxyethyl starch

Comparison of two apheresis systems for granulocyte collection without hydroxyethyl starch

Efficient granulocyte collection method using high concentrations of medium molecular weight hydroxyethyl starch

Impact of the use of hydroxyethyl starch in granulocyte apheresis using Spectra Optia

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