Efficient granulocyte collection method using high concentrations of medium molecular weight hydroxyethyl starch.
blood center operations
cellular therapy
therapeutic apheresis
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
revised:
13
04
2023
received:
28
08
2022
accepted:
22
04
2023
medline:
14
7
2023
pubmed:
9
6
2023
entrez:
9
6
2023
Statut:
ppublish
Résumé
Granulocyte transfusion therapy is a rational therapeutic option for patients with prolonged, severe neutropenia. Although high molecular weight hydroxyethyl starch (hHES) facilitates the separation of red blood cells during granulocyte collection, renal dysfunction has been noted as a potential side effect. HES130/0.4 (Voluven®) is a medium molecular weight HES (mHES) with superior safety profiles compared to hHES. Although HES130/0.4 is reportedly effective in the collection of granulocytes, we lack studies comparing the efficiency of granulocyte collection using HES130/0.4 and hHES. We retrospectively collected the data from 60 consecutive apheresis procedures performed on 40 healthy donors at the Okayama University Hospital between July 2013 and December 2021. All procedures were performed using the Spectra Optia system. Based on the HES130/0.4 concentration in the separation chamber, granulocyte collection methods using HES130/0.4 were classified into m0.46, m0.44, m0.37, and m0.8 groups. We used HES130/0.4 and hHES groups to compare the various sample collection methods. The median granulocyte collection efficiency (CE) was approximately 24.0% and 28.1% in the m0.8 and hHES groups, respectively, which were significantly higher than those in the m0.46, m0.44, and m0.37 groups. One month following granulocyte collection with HES130/0.4, no significant changes were observed in serum creatinine levels compared to those before the donation. Therefore, we propose a granulocyte collection approach employing HES130/0.4, which is comparable to the use of hHES in terms of the granulocyte CE. A high concentration of HES130/0.4 in the separation chamber was considered crucial for granulocyte collection.
Sections du résumé
BACKGROUND
Granulocyte transfusion therapy is a rational therapeutic option for patients with prolonged, severe neutropenia. Although high molecular weight hydroxyethyl starch (hHES) facilitates the separation of red blood cells during granulocyte collection, renal dysfunction has been noted as a potential side effect. HES130/0.4 (Voluven®) is a medium molecular weight HES (mHES) with superior safety profiles compared to hHES. Although HES130/0.4 is reportedly effective in the collection of granulocytes, we lack studies comparing the efficiency of granulocyte collection using HES130/0.4 and hHES.
STUDY DESIGN AND METHODS
We retrospectively collected the data from 60 consecutive apheresis procedures performed on 40 healthy donors at the Okayama University Hospital between July 2013 and December 2021. All procedures were performed using the Spectra Optia system. Based on the HES130/0.4 concentration in the separation chamber, granulocyte collection methods using HES130/0.4 were classified into m0.46, m0.44, m0.37, and m0.8 groups. We used HES130/0.4 and hHES groups to compare the various sample collection methods.
RESULTS
The median granulocyte collection efficiency (CE) was approximately 24.0% and 28.1% in the m0.8 and hHES groups, respectively, which were significantly higher than those in the m0.46, m0.44, and m0.37 groups. One month following granulocyte collection with HES130/0.4, no significant changes were observed in serum creatinine levels compared to those before the donation.
CONCLUSION
Therefore, we propose a granulocyte collection approach employing HES130/0.4, which is comparable to the use of hHES in terms of the granulocyte CE. A high concentration of HES130/0.4 in the separation chamber was considered crucial for granulocyte collection.
Substances chimiques
Hydroxyethyl Starch Derivatives
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1344-1353Informations de copyright
© 2023 AABB.
Références
Kurosawa S, Yakushijin K, Yamaguchi T, Atsuta Y, Nagamura-Inoue T, Akiyama H, et al. Changes in incidence and causes of non-relapse mortality after allogeneic hematopoietic cell transplantation in patients with acute leukemia/myelodysplastic syndrome: an analysis of the Japan transplant outcome registry. Bone Marrow Transplant. 2013;48(4):529-36.
Price TH, Boeckh M, Harrison RW, McCullough J, Ness PM, Strauss RG, et al. Efficacy of transfusion with granulocytes from G-CSF/dexamethasone-treated donors in neutropenic patients with infection. Blood. 2015;126(18):2153-61.
Freireich EJ. Leukocyte transfusion and the development of the continuous-flow blood cell separator. Transfus Med Rev. 2011;25(4):344-50.
Janes AW, Mishler JM, Lowes B. Serial infusion effects of hydroxyethyl starch on ESR, blood typing and crossmatching and serum amylase levels. Vox Sang. 1977;32(3):131-4.
Stroncek DF, Yau YY, Oblitas J, Leitman SF. Administration of G-CSF plus dexamethasone producesgreater granulocyte concentrate yields while causing nomore donor toxicity than G-CSF alone. Transfusion (Paris). 2001 Aug;41(8):1037-44.
Strauss RG, Klein HG, Leitman SF, Price TH, Lichtiger B, Martinez F, et al. Preparation of granulocyte concentrates by apheresis: collection modalities in the USA. Vox Sang. 2011;100(4):426-33.
Lee J, Leitman S, Klein H. A controlled comparison of the efficacy of hetastarch and pentastarch in granulocyte collections by centrifugal leukapheresis. Blood. 1995;86(12):4662-6.
Ikemoto J, Yoshihara S, Fujioka T, Ohtsuka Y, Fujita N, Kokubunji A, et al. Impact of the mobilization regimen and the harvesting technique on the granulocyte yield in healthy donors for granulocyte transfusion therapy. Transfusion (Paris). 2012;52(12):2646-52.
Bux J, Cassens U, Dielschneider T, Duchscherer M, Edel E, Eichler H, et al. Tolerance of granulocyte donors towards granulocyte colony-stimulating factor stimulation and of patients towards granulocyte transfusions: results of a multicentre study. Vox Sang. 2003;85(4):322-5.
Li B, Zhao H, Zhang J, Yan Q, Li T, Liu L. Resuscitation fluids in septic shock: a network meta-analysis of randomized controlled trials. Shock. 2020;53(6):679-85.
Auwerda JJA, Leebeek FWG, Wilson JHP, van Diggelen OP, Lam KH, Sonneveld P. Acquired lysosomal storage caused by frequent plasmapheresis procedures with hydroxyethyl starch. Transfusion (Paris). 2006;46(10):1705-11.
Nanya M, Yurugi K, Kato I, Hiramatsu H, Kawabata H, Kondo T, et al. Successful granulocyte apheresis using medium molecular weight hydroxyethyl starch. Int J Hematol. 2019;110(6):729-35.
Henzan T, Yamauchi T, Yamanaka I, Sakoda T, Semba Y, Hayashi M, et al. Granulocyte collection by polymorphonuclear cell-targeting apheresis with medium-molecular-weight hydroxyethyl starch. Int J Hematol. 2021;114(6):691-700.
Mandal S, Naim F, Kumar R, Gupta S, Gupta VR, Kathuria I. A pilot study on impact of use of medium molecular weight hydroxyethyl starch in granulocyte apheresis using spectra Optia. Transfus Apher Sci. 2022;61(5):103436.
Waitzinger J, Bepperling F, Pabst G, Opitz J. Hydroxyethyl starch (HES) [130/0.4], a new HES specification: pharmacokinetics and safety after multiple infusions of 10% solution in healthy volunteers. Drugs R D. 2003;4(3):149-57.
Wei L, Li D, Sun L. The comparison of albumin and 6% hydroxyethyl starches (130/0.4) in cardiac surgery: a meta-analysis of randomized controlled clinical trials. BMC Surg. 2021;21(1):342.
Jacob M, Fellahi JL, Chappell D, Kurz A. The impact of hydroxyethyl starches in cardiac surgery: a meta-analysis. Crit Care. 2014;18(6):656.
Liu FC, Liao CH, Chang YW, Liou JT, Day YJ. Hydroxyethyl starch interferes with human blood ex vivo coagulation, platelet function and sedimentation. Acta Anaesthesiol Taiwanica. 2009;47(2):71-8.
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 (Paris). 2016;56(11):2824-32.
Evans JD. Straightforward statistics for the behavioral sciences. Pacific Grove: Brooks/Cole Pub. Co.; 1996.
Klein K, Castillo B. Historical perspectives, current status, and ethical issues in granulocyte transfusion. Ann Clin Lab Sci. 2017;47(4):7.
Bolan CD, Cecco SA, Wesley RA, Horne M, Yau YY, Remaley AT, et al. Controlled study of citrate effects and response to i.v. calcium administration during allogeneic peripheral blood progenitor cell donation. Transfusion (Paris). 2002;42(7):935-46.
Bøyum A, Løvhaug D, Tresland L, Nordlie EM. Separation of leucocytes: improved cell purity by fine adjustments of gradient medium density and osmolality. Scand J Immunol. 1991;34(6):697-712.
Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358(2):125-39.
Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Åneman A, et al. Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis. N Engl J Med. 2012;367(2):124-34.
Qureshi SH, Rizvi SI, Patel NN, Murphy GJ. Meta-analysis of colloids versus crystalloids in critically ill, trauma and surgical patients. Br J Surg. 2015;103(1):14-26.
James MFM, Michell WL, Joubert IA, Nicol AJ, Navsaria PH, Gillespie RS. Resuscitation with hydroxyethyl starch improves renal function and lactate clearance in penetrating trauma in a randomized controlled study: the FIRST trial (fluids in resuscitation of severe trauma). Br J Anaesth. 2011;107(5):693-702.
Guidet B, Martinet O, Boulain T, Philippart F, Poussel JF, Maizel J, et al. Assessment of hemodynamic efficacy and safety of 6% hydroxyethylstarch 130/0.4 vs. 0.9% NaCl fluid replacement in patients with severe sepsis: the CRYSTMAS study. Crit Care. 2012;16(3):R94.
Futier E, Garot M, Godet T, Biais M, Verzilli D, Ouattara A, et al. Effect of hydroxyethyl starch vs saline for volume replacement therapy on death or postoperative complications among high-risk patients undergoing major abdominal surgery: the FLASH randomized clinical trial. JAMA. 2020;323(3):225-36.
Lee JM, Choi SJ, Kim HS, Yang M, Kim Y, Lee JW, et al. Analysis of hematologic parameters of donors, patients, and granulocyte concentrates to predict successful granulocyte transfusion. Blood Res. 2019;54(1):52-6.
Strauss RG. Commentary on white blood cell transfusions for control of infections in neutropenic patients by Vallejos C. (transfusion 1975; 15(1):28-33). Transfusion (Paris). 2022;62(4):731-9.