Large‐volume leukapheresis using femoral venous access for harvesting peripheral blood stem cells with the Fenwal CS 3000 Plus from normal healthy donors: Predictors of CD34+ cell yield and collection efficiency

Abstract

The current paper reports on the predicting factors associated with satisfactory peripheral blood stem cell collection and the efficacy of large-volume leukapheresis (LVL) using femoral vein catheterization to harvest PBSCs with Fenwal CS 3000 Plus from normal healthy donors for allogeneic transplantation. A total of 113 apheresis procedures in 57 patients were performed. The median number of MNCs, CD3+ cells, and CD34+ cells harvested per apheresis was 5.3 x 10(8)/kg (range, 0.3-11.0 x 10(8)/kg), 3.0 x 10(8)/kg (range, 0.2-6.6 x 10(8)/kg), and 7.9 x 10(6)/kg (range, 0.1-188.9 x 10(6)/kg), respectively. The median collection efficiency of MNCs and CD34+ cells was 49.8% and 49.7%, respectively. A highly significant correlation was found between the collected CD34+ cell counts and the pre-apheresis WBC counts in the donors (P = 0.013), and between the collected CD34+ cell counts and the pre-apheresis peripheral blood (PB) CD34+ cell counts (P<0.001). Harvesting at least >4 x 10(6)/kg CD34+ cells from the 1st LVL was achieved in 44 (77.2%) out of 57 donors and in 19 (90.5%) out of 21 donors with a PB-CD34+ cell count of >40/microl. There was no significant difference in the harvested MNC and CD34+ cell counts between the 1st and 2nd apheresis. The catheter-related complications included catheter obstruction (n = 2) and hematoma at the insertion site (n = 3). Accordingly, LVL using femoral venous access for allogeneic PBSC collection from normal healthy donors would appear to be safe and effective.

Poor mobilization is an independent prognostic factor in patients with malignant lymphomas treated by peripheral blood stem cell transplantation

“…[2][3][4][5][6][7][8][9][10][11][12] The presence of HSCs in peripheral blood is usually extremely low before mobilizing procedures, and engraftment of CD34 þ peripheral blood stem cells (PBSC) depends on the infusion of an adequate number of CD34 þ stem cells to restore haemopoiesis. [13][14][15][16][17][18][19][20][21][22][23] Indeed, the number of CD34 þ cells is commonly used to predict the potential engraftment of harvested HSC. 17,19,22,23 A cutoff of 20 CD34 þ cells/ml in the peripheral blood has been arbitrarily defined to predict a successful collection procedure, and an infusion of a minimum of 2.5 Â 10 6 CD34 þ cells/kg to achieve a safe engraftment.…”

“…17,19,22,23 A cutoff of 20 CD34 þ cells/ml in the peripheral blood has been arbitrarily defined to predict a successful collection procedure, and an infusion of a minimum of 2.5 Â 10 6 CD34 þ cells/kg to achieve a safe engraftment. 20,21 A good mobilization is mainly achieved by combining chemotherapy and haemopoietic growth factors (HGF).…”

Transplantation outcome in allogeneic PBSCT patients according to a new chronic GVHD grading system, including extensive skin involvement, thrombocytopenia, and progressive-type onset

“…PBSCs were mobilized with 10 mg/kg/day G-CSF (Filgrastim, Leukokine s , CJ, Co., Seoul, Korea) alone (n ¼ 12) or with 10 mg/kg/day GM-CSF (Sargramostim, Leucogen s , LG, CI, Seoul, Korea) alone (n ¼ 6), or with a concurrent regimen (n ¼ 6) with 5 mg/kg/day G-CSF and 5 mg/kg/day GM-CSF for 5 days, or with a sequential regimen (n ¼ 12) with 10 mg/kg/ day GM-CSF alone for 3 days followed by 10 mg/kg/day G-CSF alone for 2-3 days from HLA-matched sibling donors, as previously reported. 4,5 Leukaphereses were performed using a Fenwal CS 3000 þ s blood cell separator (Baxter, Healthcare, Deerfield, IL, USA) with acid-citratedextrose as the anticoagulant. For successful transplantation, the minimum target number of MNCs and CD34 þ cells was 43 Â 10 8 /kg and 43 Â 10 6 /kg, respectively.…”

Risk factors for late cytomegalovirus infection after allogeneic stem cell transplantation using HLA-matched sibling donor: donor lymphocyte infusion and previous history of early CMV infection

“…The PBSCs were harvested with a target of more than 4 Â 10 6 / kg of CD34 after mobilization treatment with G-CSF alone or a G/GM-CSF combination or sequential injections from a matched sibling donor as reported previously. 6 For the advanced disease group, additional PBSCs were collected and cryopreserved under À1701C for future DLIs in the case of a relapse or prophylactic use as previously reported. 6,7 Acute GVHD prophylaxis consisted of cyclosporin A (Cipol-N s , ChongKunDang Pharm., Seoul, Korea) beginning on day-1 and standard methotrexate therapy on D 1, 3, 6, and 11.…”

“…6 For the advanced disease group, additional PBSCs were collected and cryopreserved under À1701C for future DLIs in the case of a relapse or prophylactic use as previously reported. 6,7 Acute GVHD prophylaxis consisted of cyclosporin A (Cipol-N s , ChongKunDang Pharm., Seoul, Korea) beginning on day-1 and standard methotrexate therapy on D 1, 3, 6, and 11. For CMV prophylaxis, all patients received irradiated blood products that were depleted of leukocytes by filters, and infused intravenous immunoglobulin (500 mg/kg) every 2 weeks till day 100, and every month till 6 months.…”