Kinetics of standardized large volume leukapheresis (LVL) in patients do not show a recruitment phenomenon of peripheral blood progenitor cells (PBPC)

Abstract

Summary:Although several studies have demonstrated the efficacy of large volume leukapheresis (LVL) to yield high numbers of peripheral blood progenitor cells (PBPC), the mechanisms of stem cell release into circulation and the postulated phenomenon of PBPC recruitment during apheresis have not been investigated in detail. Therefore, we analyzed the kinetics of stem cell enrichment in a total of 34 standardized LVL for patients with hematologic malignancies (lymphoma, multiple myeloma) and solid tumors (breast cancer, rhabdomyosarcoma). LVL was started 2 h after administration of G-CSF processing six times the patient's blood volume. Cells were sequentially collected into six bags and the numbers of leukocytes, mononuclear cells (MNC), CD34 ؉ cells and colony-forming cells (CFU-GM) in each collection bag were analyzed. The numbers of PBPC collected demonstrated a continuous decrease starting after an early maximum during the second processed blood volume (P ‫؍‬ 0.001). Interestingly, these kinetics of decreasing stem cell yields during LVL were similar for both entities of patients with hematologic malignancies as well as for both groups of patients with solid tumors. In summary, a recruitment phenomenon, defined as a timedependent and LVL-induced increase of PBPC, could not be demonstrated in any of the diseases investigated. Bone Marrow Transplantation (2001) 28, 13-20.

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

“…The lowest CD34+ cell yield and collection efficiency were observed at the very beginning of LVL, which can be explained by the time required to establish interface, and by a dilution effect in the first collection bag, caused by the automated filling with saline [19,29,31]. In the remaining collection period, the CD34+ cell yield and collection efficiency were stable, without any time-dependent changes, as Bojanic,16 observed by others [9,10].…”

“…The optimal study design would be to compare products collected during the same procedure at different time, which was done in this study, and differences caused by interindividual variability were excluded. Studies of kinetics of PBSC enrichment during LVL showed variable results [3,[8][9][10][19][20][21][22][23][24][25][26][27][28][29][30][31], which could be consequence of difference in volumes of processed blood. Therefore, processed blood volume in our study was standardized and strictly related to the patient's TBV.…”

Plerixafor and granulocyte colony-stimulating factor for first-line steady-state autologous peripheral blood stem cell mobilization in lymphoma and multiple myeloma: results of the prospective PREDICT trial

“…6,7 The number of circulating hematopoietic stem cells increases during the recovery phase of chemotherapy-induced myelosuppression, as well as after the administration of various cytokines and hematopoietic growth factors including granulocyte colony-stimulating factor (G-CSF). 2,8,9 Over the last two decades, clinical practices have taken advantage of these observations. However, increasing awareness of mobilization failure with G-CSF In Europe, the combination of plerixafor + granulocyte colony-stimulating factor is approved for the mobilization of hematopoietic stem cells for autologous transplantation in patients with lymphoma and myeloma whose cells mobilize poorly.…”

Peripheral Blood Progenitor Cell Collection in Low-Weight Children

“…But recruitment has not been defined similarly by all the authors. Some authors have considered recruitment as a time-or blood process-dependent phenomenon consistent with a CD34 1 cell release in peripheral blood after the beginning of the apheresis (72,75,76,78). Some kind of PBPC mobilization by the procedure itself has been proposed, but it has not been demonstrated (72,75,77,78).…”