Factors affecting the efficacy of peripheral blood progenitor cells collections by large-volume leukaphereses with standardized processing volumes.
BACKGROUND
Peripheral blood progenitor cell (PBPC) collections should be safe and efficient. Therefore, the influence and risk factors in large-volume leukaphereses (LVL) with standardized blood volumes was investigated.


METHODS
In a total of 724 autologous LVL performed at our center, either 4x or 6x the patient's blood volume (PBV) was processed. The group with processing 4x the PBV showed a median of 31 circulating CD34+ cells per microL, and the group with processing 6x the PBV had a median of 13 CD34+ cells per microL before LVL. Individual clinical factors, laboratory factors, and apheresis run variables influencing the yields of PBPCs were retrospectively analyzed. Furthermore, the changes of laboratory variables and adverse effects during LVL were investigated.


RESULTS
Multivariate analysis identified "age,""circulating CD34+ cells," and "percentage of mononuclear cells" as only factors influencing the yields of PBPCs. Altogether, processing 6x versus 4x the PBV did not result in significantly higher yields of CD34+ cells for the total group, but requested PBPC yields were achieved more often after processing 6x the PBV in patients below 20 CD34+ cells per microL blood. Processing 6x versus 4x the PBV showed a significant difference for the decrease of platelets, but not for any other laboratory variable. Adverse effects were recorded in 4.97 percent of LVL without accumulation in one group.


CONCLUSIONS
In particular, patients with low amounts of circulating CD34+ cells profited from enlarged LVL demonstrating higher PBPC yields but comparable rates of adverse effects.
Cassens
Uwe
U
Institute of Transfusion Medicine, Department of Medical Informatics and Biomathematics, University Hospital Münster, Germany. cassenu@uni-muenster.de
Barth
Ingo Mathias
IM
Baumann
Claudia
C
Fischer
Rudolf-Josef
RJ
Kienast
Joachim
J
Vormoor
Josef
J
Sibrowski
Walter
W
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018952:Antigens, CD34 / Q000032:analysis; D001777:Blood Coagulation; D001781:Blood Component Removal; D001800:Blood Specimen Collection / Q000009:adverse effects / Q000379:methods*; D001810:Blood Volume; D002118:Calcium / Q000097:blood; D002452:Cell Count; D002469:Cell Separation / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D036102:Peripheral Blood Stem Cell Transplantation; D010976:Platelet Count; D011188:Potassium / Q000097:blood; D013234:Stem Cells / Q000166:cytology / Q000276:immunology
D018952:Antigens, CD34; D006454:Hemoglobins; D011188:Potassium; D002118:Calcium