Peripheral blood stem cell collection with reduced platelet loss to the patient/donor

Abstract

Apheresis procedures that optimize peripheral blood stem cell (PBSC) harvesting also result in a significant loss of platelets to the patient/donor because of their similar densities. We compared the percent drop in platelet count and hemoglobin concentration in the patients before and after PBSC collection using two different collection chambers with the CS-3000. A modified plateletpheresis procedure was utilized. Seven patients underwent 38 PBSC collections during steady state hematopoiesis using the standard A-35 collection chamber. At the end of the procedure, a second low-speed centrifugation of the PBSC concentrate was performed in the manual mode, with siphoning out and return of the PRP to the patient through a transfer pack. For 14 patients who underwent 113 PBSC collections, a small volume collection chamber (SVCC) was substituted for the A-35 chamber and the second centrifugation step was omitted. These patients were also primed with 4 g/m2 of cyclophosphamide. The percent drop in platelet count in the patients after the collection procedures was significantly less in the SVCC group (20.4 +/- 9.1 vs. 36.0 +/- 12.3, P = 0.000), even after correction for the difference in the volume of blood processed between the two groups (3.2 +/- 1.4 vs. 3.9 +/- 1.3, P = 0.006). The percent drop in hemoglobin concentration was also less with the SVCC both before (5.4 +/- 3.8 vs. 11.7 +/- 3.0, P = 0.000) and after (0.8 +/- 0.6 vs. 1.3 +/- 0.3, P = 0.000) correction for the difference in the volume of blood processed.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of COBE� Spectra? software version 4.7 PBSC and version 6.0 auto PBSC? program

“…However, platelet contamination was statistically higher with Version 4.7, although we did not find that this translated into an increased requirement for platelet transfusions for patients undergoing collection on Version 4.7. Nonetheless, increased platelet loss in patients undergoing PBPC harvesting is a well documented (but usually self-limiting) complication of apheresis and occasionally patients may require a prophylactic platelet transfusion prior to or immediately after apheresis [3,4]. Thus reduced platelet content in the autograft product is a potential advantage of Version 6.0.…”

Effects of G-CSF administration and peripheral blood progenitor cell collection in 20 healthy donors

“…The lowest platelet count was seen in a donor who required four apheresis sessions to obtain a sufficient amount of PBPC. Interestingly, modifications such as the use of a small-volume collection chamber for PBPCC would be of help to overcome this problem [21]. PBPCC als resulted in a significant decrease of lymphocyte counts that tended to resolve within 3 months after the procedure.…”

Peripheral blood progenitor cell grafts contain high levels of platelet‐secreted mediators

“…Bone marrow‐derived progenitor cells were previously used for autografting, but peripheral blood progenitor cells (PBPCs) are now usually preferred because of the shorter time to hematopoietic reconstitution 1,2 . PBPCs are collected from the peripheral blood (PB) by density gradient centrifugation, and, because of density similarities, the grafts may contain large numbers of normal WBCs and platelets 3–5 . Autografts can also be contaminated with malignant cells that may become responsible for posttransplant disease relapse 6–8 …”