Mononuclear cell collection in patients undergoing extra‐corporeal photo‐chemotherapy for acute and chronic graft‐vs.‐host‐disease (GvHD): Comparison between COBE Spectra version 4.7 and 6.0 (AutoPBSC)

Abstract

A constant improvement in the performance of blood cell separators has been observed in recent years, allowing better yields in peripheral blood stem cell collection (PBSC) either from healthy donors or for autologous purposes. Nevertheless, to our knowledge, no reports on the efficiency of mononuclear cell (MNC) collection in patients undergoing extra-corporeal photochemotherapy (ECP) for graft-vs.-host-disease (GvHD) have been published. We retrospectively investigated the efficiency of 167 MNC collections performed consecutively in 12 patients between January 1999 and June 2001 by means of the COBE Spectra version 4.7 (V 4.7) or version 6.0 (V 6.0), for 109 and 58 procedures, respectively. MNC fractional extraction (FE) was higher in the V 6.0 group compared to the V 4.7 group : 0.59 +/- 0.21 vs. 0.51 +/- 0.22 (P < 0.05). However, platelet contamination was lower in the products obtained with V.6.0 compared to those obtained with V.4.7: 740 ( 630 x 10(3)/(L vs. 2,073 ( 1,429 x 10(3)/(L (P < 0.05). Only two patients with acute GvHD, both from V 4.7 group, required post-ECP platelet transfusion. The recently released version 6.0 allowed a satisfactory MNC yield with minimal platelet contamination in patients scheduled to undergo ECP for acute or chronic GvHD.

The use of fluid boluses to safely perform extracorporeal photopheresis (ECP) in low‐weight children: A novel procedure

“…Perseghin et al [38] reported superior mononuclear cell (MNC) collection (p < 0.5) and less platelet contamination with the COBE software version 6 compared to version 4.6. Data were collected from 109 patients with GVHD treated using version 4.6 and 58 with version 6.…”

Update on extracorporeal photochemotherapy for graft-versus-host disease treatment

“…Pediatric experience with ECP for GvHD (to date, results on about 100 children treated are available) has mainly been reported by Italian [1][2][3][4][5][6][7][8][9] and French [10][11][12][13][14][15] groups. Most of this has been in the form of case reports or small series.…”

“…2,4,6,8,9,11,14,15,17 In 73% of them, improvement was observed, with addition of ECP to their immunosuppressive regimen. A maximal response was observed after 10-15 ECP (1-2 months of treatment).…”

“…[1][2][3][4]6,8,9,[12][13][14][15][16] The overall response was 63%. In 37% of patients, chronic GvHD was stable, or worsened.…”

“…In all, 14 of 33 Italian and four of seven French patients died of GvHD (12 patients), relapse (two patients) or infection (four patiens). 2,4,6,8,9,11,13,15 For children with chronic GvHD, follow-up ranges between 10 and 153 months with 77 and 85% of patients alive in the Italian and French series, respectively. The majority of surviving patients have a good quality of life, normal school and sport activity.…”