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

Bojanić, Ines; Dubravčić, Klara; Batinić, Drago; Ćepulić, Branka Golubić; Mazić, Sanja; Hren, Darko; Nemet, Damir; Labar, Boris

doi:10.1016/j.transci.2011.01.005

Cited by 26 publications

(30 citation statements)

References 51 publications

(104 reference statements)

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“…The importance of LVL in patients who are poor mobilizers of CD34+ cells has been highlighted in previous publications . In this study, although the majority of patients mobilized a sufficient number of CD34+ cells, LVL procedures were usually performed because the transplant centers requested the collection of a large number of cells for double or triple transplantation.…”

Section: Discussionmentioning

confidence: 93%

“…Several studies have reported the use of a “benchmarked” CD34+ collection efficiency (CE2) as a predictive tool, but most report an underestimation of the final collected dose . Leberfinger et al recently described a customized prediction algorithm that used peripheral blood CD34+ counts to calculate the blood volume required for a target CD34+ cell dose per kg patient weight …”

Section: Introductionmentioning

confidence: 99%

“…This study was conducted following the results of earlier studies investigating LVL in adult and pediatric patients with the COBE Spectra device (Terumo BCT, USA) . Here we assessed the processing of larger blood volumes using the new continuous mononuclear cell collection (CMNC) protocol on the Spectra Optia apheresis system (Terumo BCT, USA).…”

Section: Introductionmentioning

confidence: 99%

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Performance prediction algorithm for autologous PBSC collection in adults and pediatric patients using large volume leukapheresis

Bojanić

Besson

Vidović

et al. 2019

J of Clinical Apheresis

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Background and Objectives The number of CD34+ cells collected in apheresis procedures depends mainly on the collection efficiency of the device and the blood volume processed. Large volume leukapheresis (LVL) can improve CD34+ cell yield and has previously been investigated using the COBE Spectra device (Terumo BCT, USA). Materials and Methods This was a retrospective analysis of LVL performance in patients undergoing continuous mononuclear cell collection (CMNC) using the new Spectra Optia apheresis system (Terumo BCT, USA) at the University Hospital Center, Zagreb, from March 2016 to September 2016. CD34+ cell yield predictability, determined using a customized algorithm, was also assessed. Results In total, 67 procedures performed in 46 adults and 14 performed in 11 children were included in the analysis. In adults, 30 (65.2%) patients successfully reached their target preapheresis CD34+ cell count on day 1, with a median (interquartile range [IQR]) CD34+ collected cell dose of 4.8 × 106/kg (2.3‐10.6 × 106/kg). In the pediatric group, 81.8% successfully collected the target CD34+ cell dose on the first day, with a median (IQR) CD34+ collected cell dose of 11.1 × 106/kg (3.2‐16.3 × 106/kg). The customized algorithm showed a strong and significant linear correlation with actual CD34+ cell dose (P < 0.0001). Conclusion The results of this study support the use of LVL and the customized prediction algorithm in apheresis procedures. The ability to tailor the procedure to meet the needs of the individual patient may help to minimize the blood volume processed, shorten the duration, reduce the volume of infused anticoagulants, and improve patient comfort.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Performance prediction algorithm for autologous PBSC collection in adults and pediatric patients using large volume leukapheresis

Bojanić

Besson

Vidović

et al. 2019

J of Clinical Apheresis

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“…19 Several studies have provided strategies to allow larger volume apheresis collections to enhance yield and manage citrate toxicity. [20][21][22] Activating and modifying CAR T cells Robust T cell activation for CAR T cell manufacture can be achieved using soluble anti-CD3 monoclonal anitbodies (mAbs), 24 anti-CD3/anti-CD28 mAb coated paramagnetic beads 25 or cell-based engineered artificial APCs. 26,27 Bead-based methods concurrently provide a method to positively select T cells, whereas synthetic cell based artificial APCs allow for customisation of stimulatory conditions.…”

Section: Harvesting and Isolating T Cells For Car T Cell Manufacturingmentioning

confidence: 99%

Clinical Development and Manufacture of Chimeric Antigen Receptor T cells and the Role of Leukapheresis

Fesnak¹,

O’Doherty²

2017

European Oncology &Amp; Haematology

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Adoptive transfer of chimeric antigen receptor (CAR) T cells is a powerful targeted immunotherapeutic technique. CAR T cells are manufactured by harvesting mononuclear cells, typically via leukapheresis from a patient’s blood, then activating, modifying the T cells to express a transgene encoding a tumour-specific CAR, and infusing the CAR T cells into the patient. Gene transfer is achieved through the use of retroviral or lentiviral vectors, although non-viral delivery systems are being investigated. This article discusses the challenges associated with each stage of this process. Despite the need for a consistent end product, there is inherent variability in cellular material obtained from critically ill patients who have been exposed to cytotoxic therapy. It is important to carefully select target antigens to maximise effect and minimise toxicity. Various types of CAR T cell toxicity have been documented: this includes “on target, on tumour”, “on target, off tumour” and “off target” toxicity. A growing body of clinical evidence supports the efficacy and safety of CAR T cell therapy; CAR T cells targeting CD19 in B cell leukemias are the best-studied therapy to date. However, providing personalised therapy on a large scale remains challenging; a future aim is to produce a universal “off the shelf” CAR T cell.

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“…Large volume leukapheresis results in higher CD34+ cells yield per apheresis session; however patient discomfort and citrate toxicity are associated concerns. [71][72][73][74][75] Collection normally starts when CD34+ cells reach to a level of 5-20 CD34+ cells/µl. Apheresis procedures are normally safe; though common complications associated with apheresis method are citrate toxicity, thrombocytopenia, hypovolemia, catheter malfunction, microbial infection etc.…”

Section: Collection-apheresis Techniquementioning

confidence: 99%

Peripheral blood stem cells: mobilization strategies and potential therapeutic applications

Chhabra¹,

Kannaiyan²,

Palaniyandi³

et al. 2017

Int J Adv Med

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Peripheral blood stem cell (PBSC) transplantation is now a day’s preferred transplantation source of stem cells as treatment modality for various hematologic malignancies. Progenitor hematopoietic stem cells express CD34 antigen, through which PBSCs are selected and collected. Peripheral blood stem cells provide a rapid and effective hematopoietic recovery after administration in patients having hematological ailments, with the advantages of a shorter engraftment time and the lack of a need for surgical procedure necessary for bone marrow harvesting. PBSCs are routinely present in blood circulation; though number too low to be used for transplantation. PBSCs can be mobilized by the administration of G-CSF or GM-CSF alone or preceded by chemotherapy. The yield of stem cells after mobilization differ enormously with disease condition, age etc. and several studies have been performed with different mobilizing regimen and factors affecting yield of progenitor cells. Mobilized peripheral blood stem cells have been increasingly used clinically for many diseases including myeloma, leukemia, lymphoma etc. In the current review, we give brief introduction about peripheral blood stem cells, its advantages over bone marrow and emphasize on different mobilizing strategy used for mobilizing PBSCs and expansion of these PBSCs under in vitro environment. The potential clinical application of PBSCs in treating different diseases has also been reviewed here in detail.

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

Cited by 26 publications

References 51 publications

Performance prediction algorithm for autologous PBSC collection in adults and pediatric patients using large volume leukapheresis

Performance prediction algorithm for autologous PBSC collection in adults and pediatric patients using large volume leukapheresis

Clinical Development and Manufacture of Chimeric Antigen Receptor T cells and the Role of Leukapheresis

Peripheral blood stem cells: mobilization strategies and potential therapeutic applications

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