Comparison between intermittent and continuous leukapheresis protocols for autologous hematopoietic stem cell collections in children.
CMNC
MNC
apheresis
optia
Journal
Journal of clinical apheresis
ISSN: 1098-1101
Titre abrégé: J Clin Apher
Pays: United States
ID NLM: 8216305
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
14
10
2018
revised:
03
02
2019
accepted:
02
08
2019
pubmed:
20
8
2019
medline:
3
4
2020
entrez:
20
8
2019
Statut:
ppublish
Résumé
Peripheral hematopoietic stem cell (HSC) collections are needed for autologous hematopoietic stem cell transplantation (HSCT). Since 2015, our institution has utilized a secondary chamber mononuclear cell (MNC) protocol on the Spectra Optia apheresis system. Recently, a new continuous mononuclear collection protocol (CMNC) was developed for the same device. As there is limited data available regarding the use of the CMNC protocol in children, we compared collection efficiency (CE2), side effects, and clinical feasibility between the two protocols in patients <18 years old. We prospectively collected clinical, laboratory, and technical collection data from HSC collection procedures performed with the Spectra Optia apheresis system utilizing the CMNC protocol. Data were compared to retrospectively collected data utilizing the MNC protocol. Data collection included donor demographics, precollection peripheral CD34+ cell counts, total CD34+ cells collected, collection efficiency, side effects, and collection product characteristics. A total of 96 HSC collection procedures were performed on 79 pediatric patients utilizing either the MNC (61 patients) or CMNC (18 patients) protocol. The collection efficiencies were comparable between MNC and CMNC cohorts (52.9% vs 54.9%, P = 0.711). Platelet loss was significantly lower in the CMNC cohort (P = 0.002), especially in children weighing <15 kg. Product volumes were higher with CMNC. No significant collection-related side effects were noted with either protocol. MNC and CMNC protocols have comparable collection efficiencies and are both feasible and safe for the use in children. Centers may choose between the methods depending on clinical needs.
Sections du résumé
BACKGROUND
BACKGROUND
Peripheral hematopoietic stem cell (HSC) collections are needed for autologous hematopoietic stem cell transplantation (HSCT). Since 2015, our institution has utilized a secondary chamber mononuclear cell (MNC) protocol on the Spectra Optia apheresis system. Recently, a new continuous mononuclear collection protocol (CMNC) was developed for the same device. As there is limited data available regarding the use of the CMNC protocol in children, we compared collection efficiency (CE2), side effects, and clinical feasibility between the two protocols in patients <18 years old.
STUDY DESIGN AND METHODS
METHODS
We prospectively collected clinical, laboratory, and technical collection data from HSC collection procedures performed with the Spectra Optia apheresis system utilizing the CMNC protocol. Data were compared to retrospectively collected data utilizing the MNC protocol. Data collection included donor demographics, precollection peripheral CD34+ cell counts, total CD34+ cells collected, collection efficiency, side effects, and collection product characteristics.
RESULTS
RESULTS
A total of 96 HSC collection procedures were performed on 79 pediatric patients utilizing either the MNC (61 patients) or CMNC (18 patients) protocol. The collection efficiencies were comparable between MNC and CMNC cohorts (52.9% vs 54.9%, P = 0.711). Platelet loss was significantly lower in the CMNC cohort (P = 0.002), especially in children weighing <15 kg. Product volumes were higher with CMNC. No significant collection-related side effects were noted with either protocol.
CONCLUSIONS
CONCLUSIONS
MNC and CMNC protocols have comparable collection efficiencies and are both feasible and safe for the use in children. Centers may choose between the methods depending on clinical needs.
Substances chimiques
Antigens, CD34
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
646-655Subventions
Organisme : Garron Family Cancer Center
Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Chen S-H, Wang T-F, Yang K-L. Hematopoietic stem cell donation. Int J Hematol. 2013 Apr;97(4):446-455.
Yalçin B, Kremer LC, Caron HN, van Dalen EC. High-dose chemotherapy and autologous haematopoietic stem cell rescue for children with high-risk neuroblastoma. Cochrane Database Syst Rev 2013;8:CD006301. https://doi.org/10.1002/14651858.CD006301.pub3.
Shih C-S, Hale GA, Gronewold L, et al. High-dose chemotherapy with autologous stem cell rescue for children with recurrent malignant brain tumors. Cancer. 2008 Mar 15;112(6):1345-1353.
Garfin PM, Link MP, Donaldson SS, et al. Improved outcomes after autologous bone marrow transplantation for children with relapsed or refractory Hodgkin lymphoma: twenty years experience at a single institution. Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant. 2015 Feb;21(2):326-334.
Spectra Optia Apheresis System. [Internet]. [cited May 16, 2018]. Available from: https://www.terumobct.com/Spectra-Optia
Lisenko K, Pavel P, Bruckner T, et al. Comparison between intermittent and continuous spectra optia leukapheresis systems for autologous peripheral blood stem cell collection. J Clin Apheresis. 2017 Feb;32(1):27-34.
Brauninger S, Bialleck H, Thorausch K, Seifried E, Bonig H. Mobilized allogeneic peripheral stem/progenitor cell apheresis with spectra optia v.5·0, a novel, automatic interface-controlled apheresis system: results from the first feasibility trial. Vox Sang. 2011;101(3):237-246.
Del Fante C, Scudeller L, Martinasso A, Viarengo G, Perotti C. Comparison of two automated mononuclear cell collection systems in patients undergoing extracorporeal photopheresis: a prospective crossover equivalence study. Transfusion. 2016;56(8):2078-2084.
Cancelas JA, Scott EP, Bill JR. Continuous CD34+ cell collection by a new device is safe and more efficient than by a standard collection procedure: results of a two-center, crossover, randomized trial. Transfusion. 2016 Nov;56(11):2824-2832.
Putensen D, Smith R, Pilcher L, Trandafir G. Comparison of the CMNC and MNC apheresis protocol for the collection of T-cells showed comparable outcome: an observational study in a single centre. J Clin Apheresis. 2018 Feb 21;33:349-356.
Michon B, Moghrabi A, Winikoff R, et al. Complications of apheresis in children. Transfusion. 2007 Oct;47(10):1837-1842.
Neyrinck MM, Vrielink H. Calculations in apheresis. J Clin Apheresis. 2015;30(1):38-42.
Linderkamp O, Versmold HT, Riegel KP, Betke K. Estimation and prediction of blood volume in infants and children. Eur J Pediatr. 1977 Aug 12;125(4):227-234.
Lemmens HJM, Bernstein DP, Brodsky JB. Estimating blood volume in obese and morbidly obese patients. Obes Surg. 2006 Jun;16(6):773-776.
Ford CD, Greenwood J, Strupp A, Lehman CM. Change in CD34+ cell concentration during peripheral blood progenitor cell collection: effects on collection efficiency and efficacy. Transfusion. 2002;42(7):904-911.
Haylock DN, Canty A, Thorp D, Dyson PG, Juttner CA, To LB. A discrepancy between the instantaneous and the overall collection efficiency of the Fenwal CS3000 for peripheral blood stem cell apheresis. J Clin Apheresis. 1992;7(1):6-11.
Even-Or E, Eden-Walker A, Di Mola M, et al. Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients: pediatric stem cell apheresis efficiency. Transfusion. 2017;57(1):122-130.
Flommersfeld S, Bakchoul T, Bein G, Wachtel A, Loechelt C, Sachs UJ. A single center comparison between three different apheresis systems for autologous and allogeneic stem cell collections. Transfus Apher Sci Off J World Apher Assoc Off J Eur Soc Haemapheresis. 2013;49(3):428-433.
Cherqaoui B, Rouel N, Auvrignon A, et al. Peripheral blood stem cell collection in low-weight children: retrospective comparison of two apheresis devices. Transfusion. 2014 May;54(5):1371-1378.
Drezet A, Granata A, Lemarie C, Calmels B, Chabannon C. An intra-patient comparison of blood cell separators spectra and optia in patients and donors undergoing blood mononuclear cell collections at a single institution for subsequent autologous or allogeneic hematopoietic cell transplantation reveals comparable collection efficiencies. Bone Marrow Transplant. 2016;51(7):1007-1009.
Brauninger S, Bialleck H, Thorausch K, Felt T, Seifried E, Bonig H. Allogeneic donor peripheral blood “stem cell” apheresis: prospective comparison of two apheresis systems. Transfusion. 2012;52(5):1137-1145.
Sörensen J, Jarisch A, Smorta C, et al. Pediatric apheresis with a novel apheresis device with electronic interface control. Transfusion. 2013 Apr 1;53(4):761-765.
Spínola A, Ferreira S, Amado F, Lopes S, Roncon S. Hematopoietic progenitor cells collection in pediatric patients with brain tumor. J Clin Apheresis. 2016;31(1):22-28.
Sanderson F, Poullin P, Smith R, et al. Peripheral blood stem cells collection on spectra optia apheresis system using the continuous mononuclear cell collection protocol: a single center report of 39 procedures. J Clin Apheresis. 2017 Jun;32(3):182-190.
Mohammadi AM, Norooznezhad AH, Aminian P, et al. An alternative method for custom prime: a case report of successful peripheral blood stem cell harvesting from two low-weight child donors. Transfus Apher Sci Off J World Apher Assoc Off J Eur Soc Haemapheresis. 2017;56(6):886-888.
Ghielmini M, Pfister U, Zucca E, et al. Distribution of mobilized progenitor cells in the Buffy coat of the Haemonetics MCS3p cell separator: a study to optimize the collection of progenitors by Leukapheresis. J Hematother. 1998;7(3):251-256.
Ito Y, Shinomiya K. A new continuous-flow cell separation method based on cell density: principle, apparatus, and preliminary application to separation of human buffy coat. J Clin Apheresis. 2001;16(4):186-191.
Long G, Waller EK, Gregurek S, Tricot G, Marschner S, Bill J. Evaluation of the spectra Optia® mononuclear cell collection procedure in multiple myeloma patients. J Clin Apheresis. 2015;30(1):1-7.
Reinhardt P, Brauninger S, Bialleck H, et al. Automatic interface-controlled apheresis collection of stem/progenitor cells: results from an autologous donor validation trial of a novel stem cell apheresis device. Transfusion. 2011;51(6):1321-1330.
Flommersfeld S, Sohlbach K, Jaques G, et al. Collection of peripheral blood progenitor cells on day 4 is feasible and effective while reducing granulocyte-colony-stimulating factor exposure to healthy donors. Transfusion. 2015;55(6):1269-1274.