title: Prospective evaluation of cell kinetics, yields and donor experiences during a single large-volume apheresis versus two smaller volume consecutive day collections of allogeneic peripheral blood stem cells.
abstract: We report cell kinetics, yields and donation experiences of 20 demographically matched allogeneic peripheral blood stem cell (PBSC) donors who were prospectively assigned to undergo either a single 25 l or two consecutive daily 15 l (15 l x 2) apheresis procedures. Procedures were performed using prophylactic intravenous calcium administration after standard granulocyte colony-stimulating factor (GCSF) mobilization (10 microg/kg/d). Central line placements (two each), initial CD34 cell counts (0.077 vs 0.078 x 10(9)/l) and yields (7.9 vs 8.1 x 10(8) CD34 cells) were similar in the two groups; however, 25 l donors spent significantly less time both in the clinic (7.5 vs 10.8 h) and with central venous catheters in place (8.5 vs 29.5 h) than 15 l x 2 donors. End-procedure platelet counts were below 100 x 10(9)/l in one out of 10 25 l donors versus five out of 10 in 15 l x 2 donors (41%vs 53% mean decrease in platelet counts, P = 0.02). PBSC collection efficiency increased by 37% after 15 l of the 25-l volume had been processed, compared with no significant change during 15 l x 2 procedures. Results similar to these prospective findings were also observed in CD34 yields, symptoms and platelet counts in additional 25 l and 15 l procedures performed during the same period and evaluated retrospectively. This study indicates that a single 25-l apheresis procedure results in similar yields and symptoms, but less donor thrombocytopenia and inconvenience than two consecutive daily 15-l procedures.
authors.affiliation: Department of Transfusion Medicine, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA. cbolan@mail.cc.nih.gov
authors.forename: Charles D
authors.initials: CD
authors.lastname: Bolan
authors.forename: Charles S
authors.initials: CS
authors.lastname: Carter
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wesley
authors.forename: Yu Ying
authors.initials: YY
authors.lastname: Yau
authors.forename: A John
authors.initials: AJ
authors.lastname: Barrett
authors.forename: Richard W
authors.initials: RW
authors.lastname: Childs
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Read
authors.forename: Susan F
authors.initials: SF
authors.lastname: Leitman
mesh_terms: D000328:Adult; D018952:Antigens, CD34; D001781:Blood Component Removal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000209:etiology; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D018952:Antigens, CD34