Increasing the collection flow rate to 2 mL/min is effective and reduces the procedure time in off-line photopheresis.
MNC purity
buffy coat
collection flow rate 2
off-line ECP
photopheresis
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
revised:
03
06
2023
received:
25
03
2023
accepted:
04
06
2023
medline:
14
8
2023
pubmed:
9
7
2023
entrez:
9
7
2023
Statut:
ppublish
Résumé
Extracorporeal photopheresis (ECP) treatment, mostly based on apheresis technology, is used for immunomodulation in various diseases such as cutaneous T-cell lymphoma, graft versus host disease and other (auto)immune disorders. The aim of this study was to collect high cell counts and purity in shorter procedure times using an ECP off-line system with an increased collection flow rate of 2 mL/min to a target volume of 200 mL buffy coat. In this prospective study, data of routinely performed off-line photopheresis treatments were collected and analyzed at the Central Institute for Blood Transfusion & Department of Immunology (ZIB) of the Tirol Kliniken, to assess absolute cell counts and procedure times and to calculate collection efficiencies (CE2). A total of 22 patients participated in this study. The processed blood volume was 4312 mL, the collection time 120 min, overall procedure time 157 min and the absolute cell counts of treated white blood cells (WBC) and mononuclear cells (MNC) were 5.0 and 4.3 × 10 The data presented in this study show high therapeutically effective cell counts collected with a high MNC purity within a shorter overall collection/procedure time due to an increased collection flow rate.
Sections du résumé
BACKGROUND
Extracorporeal photopheresis (ECP) treatment, mostly based on apheresis technology, is used for immunomodulation in various diseases such as cutaneous T-cell lymphoma, graft versus host disease and other (auto)immune disorders. The aim of this study was to collect high cell counts and purity in shorter procedure times using an ECP off-line system with an increased collection flow rate of 2 mL/min to a target volume of 200 mL buffy coat.
STUDY DESIGN AND METHODS
In this prospective study, data of routinely performed off-line photopheresis treatments were collected and analyzed at the Central Institute for Blood Transfusion & Department of Immunology (ZIB) of the Tirol Kliniken, to assess absolute cell counts and procedure times and to calculate collection efficiencies (CE2).
RESULTS
A total of 22 patients participated in this study. The processed blood volume was 4312 mL, the collection time 120 min, overall procedure time 157 min and the absolute cell counts of treated white blood cells (WBC) and mononuclear cells (MNC) were 5.0 and 4.3 × 10
CONCLUSION
The data presented in this study show high therapeutically effective cell counts collected with a high MNC purity within a shorter overall collection/procedure time due to an increased collection flow rate.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1546-1553Informations de copyright
© 2023 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB.
Références
Knobler R, Berlin G, Calzavara-Pinton P, et al. Guidelines on the use of extracorporeal photopheresis. J Eur Acad Dermatol Venereol. 2014;28(Suppl 1):1-37.
Knobler R, Arenberger P, Arun A, Assaf C, Bagot M, Berlin G, et al. European dermatology forum-updated guidelines on the use of extracorporeal photopheresis 2020-part 1. J Eur Acad Dermatol Venereol. 2020;34(12):2693-716.
Knobler R, Arenberger P, Arun A, Assaf C, Bagot M, Berlin G, et al. European dermatology forum: updated guidelines on the use of extracorporeal photopheresis 2020-part 2. J Eur Acad Dermatol Venereol. 2021;35(1):27-49.
Arora S, Setia R. Extracorporeal photopheresis: review of technical aspects. Asian J Transfus Sci. 2017;11(2):81-6.
van Iperen HP, Beijersbergen van Henegouwen GM. Clinical and mechanistic aspects of photopheresis. J Photochem Photobiol B. 1997;39(2):99-109.
Worel N, Lehner E, Führer H, Kalhs P, Rabitsch W, Mitterbauer M, et al. Extracorporeal photopheresis as second-line therapy for patients with acute graft-versus-host disease: does the number of cells treated matter? Transfusion. 2018;58(4):1045-53.
Hackstein H, Amoros JJ, Bein G, et al. Successful use of miniphotopheresis for the treatment of graft-versus-host disease. Transfusion. 2014;54(8):2022-7.
Perseghin P, Galimberti S, Balduzzi A, Bonanomi S, Baldini V, Rovelli A, et al. Extracorporeal photochemotherapy for the treatment of chronic graft-versus-host disease: trend for a possible cell dose-related effect? Ther Apher Dial. 2007;11(2):85-93.
Mayer W, Kontekakis A, Maas C, Kuchenbecker U, Behlke S, Schennach H. Comparison of procedure times and collection efficiencies using integrated and multistep nonintegrated procedures for extracorporeal photopheresis. J Clin Apher. 2022;37(4):332-9.
Neyrinck MM, Vrielink H. Calculations in apheresis. J Clin Apher. 2015;30(1):38-42.
Helmberg W, Sipurzynski S, Groselje-Strehle A, Greinix H, Schlenke P. Does offline beat inline treatment: investigation into extracorporeal photopheresis. Transfus Med Hemother. 2020;47(3):198-204.
Cid J, Carbassé G, Suárez-Lledó M, Moreno DF, Martínez C, Gutiérrez-García G, et al. Efficacy and safety of one-day offline extracorporeal photopheresis schedule processing one total blood volume for treating patients with graft-versus-host disease. Transfusion. 2019;59(8):2636-42.
Brosig A, Hähnel V, Orsó E, Wolff D, Holler E, Ahrens N. Technical comparison of four different extracorporeal photopheresis systems. Transfusion. 2016;56(10):2510-9.
Bertani G, Santoleri L, Ferri U, Marenco P, Grillo G, Zucchetti E, et al. Response of steroid-refractory chronic graft-versus-host disease to extracorporeal photopheresis correlates with the dose of CD3+ lymphocytes harvested during early treatment cycles. Transfusion. 2016;56(2):505-10.
Bueno JL, Alonso R, Gonzalez-Santillana C, Naya D, Romera I, Alarcón A, et al. A paired trial comparing mononuclear cell collection in two machines for further inactivation through an inline or offline extracorporeal photopheresis procedure. Transfusion. 2019;59(1):340-6.
Di Biaso I, Di Maio L, Bugarin C, et al. Regulatory T cells and extracorporeal photochemotherapy: correlation with clinical response and decreased frequency of proinflammatory T cells. Transplantation. 2009;87(9):1422-5.
Azar N, Leblond V, Ouzegdouh M, Button P. A transition from using multi-step procedures to a fully integrated system for performing extracorporeal photopheresis: a comparison of costs and efficiencies. J Clin Apher. 2017;32(6):474-8.
Piccirillo N, Putzulu R, Massini G, di Giovanni A, Chiusolo P, Sica S, et al. Inline extracorporeal photopheresis: evaluation of cell collection efficiency. Transfusion. 2019;59(12):3714-20.
Grabmer C, Schlager S, Mayer G, Streif D, Lener T, Schallmoser K, et al. An alternative mini buffy coat preparation method for adult patients with extracorporeal photopheresis contraindications. J Clin Apher. 2017;32(1):12-5.
Liu C, Shah K, Dynis M, Eby CS, Grossman BJ. Linear relationship between lymphocyte counts in peripheral blood and buffy coat collected during extracorporeal photopheresis. Transfusion. 2013;53(11):2635-43.
Piccirillo N, Putzulu R, Massini G, di Giovanni A, Giammarco S, Metafuni E, et al. Inline and offline extracorporeal photopheresis: device performance, cell yields and clinical response. J Clin Apher. 2021;36(1):118-26.
Kuzmina Z, Greinix HT, Knobler R, Worel N, Kouba M, Weigl R, et al. Proportions of immature CD19+CD21- B lymphocytes predict the response to extracorporeal photopheresis in patients with chronic graft-versus-host disease. Blood. 2009;114(3):744-6.
Pascual C, González-Arias E, Pérez-Corral AM, et al. Mononuclear cell collection for extracorporeal photopheresis by using the "off-line" system: a comparative study between COBE spectra and spectra optia devices. J Clin Apher. 2019;34(4):359-66.
Hautmann AH, Wolff D, Hahn J, Edinger M, Schirmer N, Ammer J, et al. Extracorporeal photopheresis in 62 patients with acute and chronic GVHD: results of treatment with the COBE spectra system. Bone Marrow Transplant. 2013;48(3):439-45.
Greinix HT, Worel N, Just U, Knobler R. Extracorporeal photopheresis in acute and chronic graft-versus-host disease. Transfus Apher Sci. 2014;50(3):349-57.
Iniesta P, Revilla N, Chen-Liang TH, Hurtado AM, Vicente V, Heras I, et al. An early increase of CD56(bright) natural killer subset as dominant effect and predictor of response to extracorporeal photopheresis for graft-versus-host disease. Transfusion. 2018;58(12):2924-32.
Franklin C, Bruderek K, Schilling B, Brandau S. Chemoirradiated neutrophils and T cells differentially affect immune functions of APCs. J Leukoc Biol. 2019;106(2):481-93.
Jones HR, Robb CT, Perretti M, Rossi AG. The role of neutrophils in inflammation resolution. Semin Immunol. 2016;28(2):137-45.
Vieyra-Garcia PA, Wolf P. Extracorporeal photopheresis: a case of immunotherapy ahead of its time. Transfus Med Hemother. 2020;47(3):226-35.
Yakut E, Jakobs C, Peric A, Michel G, Baal N, Bein G, et al. Extracorporeal photopheresis promotes IL-1β production. J Immunol. 2015;194(6):2569-77.
Braun LM, Zeiser R. Immunomodulatory therapies for the treatment of graft-versus-host disease. Hemasphere. 2021;5(6):e581.
Franklin C, Cesko E, Hillen U, Schilling B, Brandau S. Modulation and apoptosis of neutrophil granulocytes by extracorporeal photopheresis in the treatment of chronic graft-versus-host disease. PLoS One. 2015;10(8):e0134518.