An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF

Hill, Quentin A.; Buxton, Denis B.; Pearce, R; Gesinde, Moji; Smith, Graeme; Cook, Gordon

doi:10.1038/sj.bmt.1705847

Cited by 11 publications

(13 citation statements)

References 29 publications

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“…Another unique quality of the Optia device is the secondary separation in the chamber according to size, which separates the PLTs from the MNC to return to the patient. 22 However, in our hands this did not translate into a significant advantage in regard to the decrease in PLTs during the procedures in our study, as opposed to Cherqaoui and colleagues 16 who have demonstrated an advantage with the Optia in this respect in low-weight children.…”

Section: Discussioncontrasting

confidence: 84%

Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients

et al. 2016

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BACKGROUND: Peripheral stem cell collections can be challenging in the pediatric population and respective experience is limited. Since February 2015 our institution is utilizing the new Spectra Optia (Optia) apheresis device, which has replaced the former COBE Spectra (COBE) device. As a quality initiative we collected and compared collection efficiency (CE2) and other collection variables between the two devices. STUDY DESIGN AND METHODS:In this retrospective study we collected and compared clinical, laboratory, and technical collection data from stem cell collection procedures done with the Optia and COBE devices. The collected data included patient demographics, precollection peripheral CD341 cell counts, total CD341 cells collected, complete blood count, electrolytes before and after collection, side effects attributed to the collection, total blood volumes processed (TBVs), collection times, and calculated CE2 and collection ratios.RESULTS: Forty-one collection procedures performed on 29 pediatric patients with the Optia device were compared to 41 collections performed on 27 patients with the COBE device. The TBVs through the Optia device were significantly smaller than the COBE (3.9 6 0.2 3 TBV vs. 5.5 6 0.1 3 TBV, respectively; p < 0.001), requiring significantly less anticoagulant and providing similar amounts of stem cells while collection times were significantly shorter (mean, 238 6 9 min vs. 264 6 9 min, respectively; p < 0.05). Collections on the Optia caused significantly smaller reductions of plasma calcium and magnesium. No significant side effects attributed to the procedure were noted.CONCLUSION: Stem cell apheresis with the Optia device in children is safe and feasible with smaller blood volumes with shorter collection times.A utologous stem cell transplantation (ASCT) is an integral part of the treatment of various pediatric cancers including high-risk neuroblastoma, various brain tumors, retinoblastoma, bone and soft tissue sarcomas, and lymphomas.1-5 The initial part of the ASCT process requires collection of stem cells, which can be challenging in the pediatric population, especially for low-weight patients such as babies and toddlers, who are more prone to hemodynamic influences of fluid shifts due to the circulating blood volumes and to the exposure to anticoagulants and who may have more difficulty with the prolonged duration of the collection procedure.6-8Our medical center performs approximately 50 ASCTs per year for pediatric patients. In February 2015 our institution introduced the novel Spectra Optia MNC (Optia) apheresis device for the collection of mobilized peripheral stem cells, which has eventually replaced the former COBE Spectra (COBE) device (both from TerumoBCT).Both devices use centrifugation for blood separation, but have some major mechanical differences. The Optia ABBREVIATIONS: ASCT(s) 5 autologous stem cell transplantation(s); BW 5 body weight; CR(s) 5 collection ratio(s); iCa 5 ionized calcium; TBV(s) 5 total blood volume(s) processed. device has a more advanced au...

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Section: Discussioncontrasting

confidence: 84%

Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients

et al. 2016

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“…Beginning in 2004, mobilization has been performed routinely with the growth factor alone. This new regimen has improved patient convenience; virtually all patients who undergo SCT at Mayo Clinic are nonresidents of Olmsted County, Minnesota (where the clinic is located), and eliminating CY from the mobilization regimen has decreased the duration of mobilization treatment by approximately 9 days 11. Subsequently, our group showed that the fraction of patients achieving a partial response after induction chemotherapy has no impact on PFS and overall survival after transplantation.…”

Section: Introductionmentioning

confidence: 88%

Comparison of high-dose CY and growth factor with growth factor alone for mobilization of stem cells for transplantation in patients with multiple myeloma

Gertz

Kumar

Lacy

et al. 2008

Bone Marrow Transplant

109

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We retrospectively analyzed outcomes of 716 patients with multiple myeloma who were mobilized using CY and growth factor (n ¼ 370) or growth factor alone (n ¼ 346) before SCT. Patients receiving CY had higher stem cell yields than the growth factor only group (median number of apheresis sessions needed to achieve stem cell collection goals, two vs four sessions, respectively (P ¼ 0.001)). However, patients treated with CY required more time for engraftment of platelets and neutrophils (Po0.001 for both). For patients receiving CY, 75% achieved engraftment (defined as a platelet count of 50 Â 10 9 /l) by day 39, whereas 75% of patients not receiving CY achieved engraftment by day 18. Similar results were observed for neutrophil engraftment. These differences did not affect the duration of hospitalization, but patients treated with CY had a higher incidence of post transplant nonstaphylococcal bacteremia. For CY-mobilized patients, considerably faster platelet engraftment (5 fewer days) resulted if stem cell reinfusion occurred more than 30 days after the first apheresis session. Our data suggested that CY damaged the microenvironment and slowed engraftment. By lengthening the period between the completion of apheresis and stem cell reinfusion, the microenvironment may recover and result in faster engraftment.

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“…than in the other two groups were observed. Engraftment took place in the same time than in the A and B: granulocyte engraftment occurred after a median of 12 days (9-18) in group C, of 11 days (8)(9)(10)(11)(12)(13)(14)(15)(16)(17) in group B and of 11 days (8-25) in group A; platelet engraftment in group C was reached after a median of 12 days (6-36), in group B after a median of 12 days (6-37), and in group A after a median of 12 days (6-37). No differences were observed in hospitalization days, infectious complication, neither transfusion requirements among groups.…”

Section: Resultsmentioning

confidence: 96%

“…The concurrence of different chemotherapy regimens and G-CSF treatment increases the release of CD34 1 cells to the PB [4,11,[13][14][15][16]. The amount of CD34 1 cells mobilized greatly varies patient wise, depending on: diagnoses, previous chemotherapy and, probably, other poorly known factors [11,17,18]. The yield of CD34 1 cells per apheresis depends on mobilizing agents and other factors, the most important are: the number of previous chemotherapy cycles, the time elapsed between the last chemotherapy and the apheresis procedure, and the amount of PBPCs at the beginning of the apheresis [19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 98%

Large‐volume‐apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients

Majado

Minguela

González-García

et al. 2009

J of Clinical Apheresis

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Given that pre-apheresis CD34(+) cell count (PA-CD34) predicts the apheresis' yield, a minimum of 5 to 20 PA-CD34/microl is required in many institutions to initiate cell collection. The aim of this study was to clarify whether large-volume-apheresis (LVA) could facilitate progenitor cell transplantation in patients with low PA-CD34. Apheresis was initiated in 226 patients, disregarding PA-CD34, at days: +5 in G-CSF, +10 in cyclophosphamide+G-CSF, and +15 to +20 in other chemotherapy+G-CSF mobilization, when leucocytes >2.5 x 10(9)/L. Four times the blood volume was processed. Patients were grouped according to their PA-CD34: >or=10/microl (group-A, n = 143); <10/microl but >or=5/microl (group-B, n = 40) and <5/microl (group-C, n = 43). No differences were found in diagnoses, gender, age, previous treatments or mobilization regimen between groups. Enough CD34(+) cells (>1.9 x 10(6)/kg) were obtained in 31 patients (72%) from group-C, although in this group two mobilizations were needed in 20 patients (46.5%), compared to 5 (3.5%) and 1 (2.5%) in groups A and B, respectively (P < 0.01). Evenly three apheresis or more were required in 28 patients (65.1%) from group-C, compared to 8 (5.6%) and 6 (15.0%) in groups A and B, respectively (P < 0.01). In conclusion LVA can facilitate autologous transplantation in poor-mobilizer-patients, low PA-CD34 should not be an inflexible exclusion factor.

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An analysis of the optimal timing of peripheral blood stem cell harvesting following priming with cyclophosphamide and G-CSF

Cited by 11 publications

References 29 publications

Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients

Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients

Comparison of high-dose CY and growth factor with growth factor alone for mobilization of stem cells for transplantation in patients with multiple myeloma

Large‐volume‐apheresis facilitates autologous transplantation of hematopoietic progenitors in poor mobilizer patients

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