title: Peripheral blood stem cell collection in multiple myeloma: a retrospective analysis of 6 years leukapheresis activity in 109 patients treated at the Istituto Nazionale dei Tumori of Milan.
abstract: Double autologous stem cell transplantation is the standard treatment in newly diagnosed multiple myeloma (MM) patients younger than 65 years; therefore, optimization of leukapheresis is crucial. We performed a retrospective analysis of 297 leukaphereses comparing semiautomated (V4.7 in 20% of collections) versus automated (V6.0 in 80%) Caridian (COBE) Spectra versions and analyzing the influence of M-protein on the outcome. Both methods gave comparable collection efficiencies (CE%) (53.4% vs. 55.7% in V6.0 and V4.7, respectively) with similar leukapheresis time and processed volume. Harvest volume was higher in V4.7 (P < 0.0001) with similar contamination of red blood cells (RBCs) (P = 0.77) and platelets (P = 0.09) when compared with V6.0. In patients with higher peripheral white blood cells (WBCs), V6.0 with adjusted harvest volume (<700 mL), achieved similar CD34(+) CE% (P = 0.39) and better enrichment of nucleated cells (P < 0.0,002) but higher RBCs (P < 0.0,001) and platelets contamination (P = 0.001), when compared with a larger cycle volume in patients with lower WBCs. In hard to mobilize patients, CD34(+) CE% was significantly more efficient with V4.7 than V6.0 (P < 0.0,001). CD34(+) CE% was unaffected by serologic M-protein, but platelet CE% was higher in the absence of M-protein (P = 0.0,003), without any reduction in peripheral patients platelets. We, therefore, conclude that in the setting of MM patients with a high WBCs count and/or low percentage of peripheral CD34(+) cells, collections with V4.7 or adjusted cycle volume V6.0 gave comparable result in CD34(+) CE%. RBCs and platelets contamination is higher if low cycle volume is chosen. In hard to mobilize patients, V4.7 is advisable.
authors: Department of Pathology, Laboratory and Transfusion Medicine, Immunohematology and Transfusion Medicine Service, Fondazione IRCCS, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. paola.coluccia@istitutotumori.mi.it
authors: Paola
authors: P
authors: Coluccia
authors: Vittorio
authors: V
authors: Montefusco
authors: Sara
authors: S
authors: Tunesi
authors: Mario
authors: M
authors: Avella
authors: Alvaro
authors: A
authors: Bompadre
authors: Paolo
authors: P
authors: Longoni
authors: Marco
authors: M
authors: Milanesi
authors: Adriano
authors: A
authors: De Carli
authors: Fernando
authors: F
authors: Ravagnani
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D012189:Retrospective Studies; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34