Large‐volume leukapheresis yields more viable CD34+ cells and colony‐forming units than normal‐volume leukapheresis, especially in patients who mobilize low numbers of CD34+ cells

Abstract

Although a median platelet loss of 36 percent can be expected, LVL can be recommended as the standard apheresis method for PBPC collections in patients with malignant diseases. LVL is particularly useful in patients who mobilize a low number of CD34+ cells into the peripheral blood.

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

“…Processing of larger blood volumes in single LVL may improve CD34+ cell yield, consequently reducing the number of required procedures and diminishing the total cost of collections [2,4]. Another rationale for use of LVL is the narrow peak of the CD34+ cells in the peripheral blood, present only for a short period after mobilization, and therefore the optimal time for successful collection would not likely be missed [14].…”

“…Results of previous studies which compared standard vs. LVL processing varied considerably [2,4,10,[14][15][16][17][18]. It is difficult to establish a control group with comparable patients due to high interindividual variability regarding patients' characteristics, such as age, gender, TBV, stage of disease, previous treatment, and baseline blood count values.…”

“…TBVs and cells collected while processing the fifth and sixth TBVs are presented in table 4. The CD34+ cell subset analysis revealed no significant difference in the composition Bojanic,12 of products collected during different stages of LVL.…”

“…Patients were monitored for adverse reactions and recorded reactions were classified according to National Cancer Institute Common Toxicity Criteria (CTC-NCI) Classification, Version 2 [4]. In order to prevent symptoms of hypocalcemia all patients during LVL received 0.5 g calcium chloride/10 kg BW in 100 ml of saline solution.…”

“…An alternative to repeated aphereses could be processing larger volumes of blood during one procedure. Large-volume leukapheresis (LVL) involves processing patient's total blood volume (TBV) at least three times during single procedure, and differs from standard leukapheresis by processing larger blood volume, increasing blood flow rate, use of additional anticoagulant heparin and longer duration of procedure [1][2][3][4][5]. Unfortunately, there is no standardized protocol for LVL and between centers there are differences regarding blood volume processed and duration of…”