A Single Center 25-year Experience in Autologous Peripheral Blood Stem Cell Collection: A Focus on the Collection Efficiency

Gessoni Gianluca *

Dipartimento di Medicina Trasfusionale, ULSS 3 Serenissima, Ospedale dell’Angelo, Mestre (Venezia), Italy.

De Fusco Giulia

Dipartimento di Medicina Trasfusionale, ULSS 3 Serenissima, Ospedale dell’Angelo, Mestre (Venezia), Italy.

Polese Francesca

Dipartimento di Medicina Trasfusionale, ULSS 3 Serenissima, Ospedale dell’Angelo, Mestre (Venezia), Italy.

Frigato Andrea

Dipartimento di Medicina Trasfusionale, ULSS 5 Polesana, Presidio Ospedaliero Santa Maria della Misericordia, Rovigo, Italy.

Marson Piero

Dipartimento di Medicina Trasfusionale, Azienda Ospedale Università di Padova, Italy.

*Author to whom correspondence should be addressed.


Abstract

Background: Harvest of hematopoietic progenitor cells via leukapheresis is being used increasingly for autologous transplantation. Adequate yield of cells per kilogram body weight of recipient is required for a successful engraftment. Collection efficiency (CE) is a useful parameter to assess quality of peripheral blood stem cell (PBSC) collection program. In this study, we report a 25-year experience in a tertiary care Hospital in Italy.

Patients and Methods: 1,026 consecutives autologous PBSC collection procedure, performed in 763 patients, from January 1996 to December 2020 were retrospectively considered. Data regarding patients, Blood Cells Separators (BCS) , apheresis procedures and PBSC products were collected in our database. In these 25 years different BCS were adopted in our Apheresis Unit (AU). In the first period (1996-1999) we used Fresenius Com. Tec, in the central period (2000-2013) we used Cobe Spectra and in the last period (2014-2020) Spectra Optia.

Results: As regards the evaluation of patients before leukapheresis, the most significant data was the increasing number of CD34+ cells. Considering the PBSC collection procedure, there was a progressive increase in the processed blood volume with a shorter apheresis duration. Data related to the PBSC collection demonstrated an increasing CD34+ cell yield and efficiency a raise in CE that was 43% using Fresenius COM-TEC BCS, 49% using Cobe Spectra BCS and 53% using Spectra Optia BCS. .

Conclusions: These results were observed considering a 25-year period, thus a great number of factors likely contributing to the observed results, including technological improvement of the instrumentation for leukapheresis, increased experience of the team operating in the Apheresis Unit, improved mobilization protocols, better criteria for patients’ selection. Focusing our attention on CE  we observed quite satisfactory results with a median which rose from 43% to 53% with an increase of 10% in the observation period.

Keywords: Autologous PBSC collection, CD34 cells, collection efficiency, leukapheresis


How to Cite

Gianluca, G., Giulia, D. F., Francesca, P., Andrea, F., & Piero, M. (2023). A Single Center 25-year Experience in Autologous Peripheral Blood Stem Cell Collection: A Focus on the Collection Efficiency. International Blood Research & Reviews, 14(1), 15–28. https://doi.org/10.9734/ibrr/2023/v14i1298

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References

Miller JP, Perry EH, Price TH, Bolan Jr CD, Karanes C, Boyd TM. et al. Recovery and safety profiles of marrow and PBSC donors: experience of the National Marrow Donor Program. Biol Blood Marrow Transplant. 2008;14(9 Suppl):29-36.

Candoni A, Rambaldi A, Fanin R, Velardi A, Arcese W, Ciceri F, et al. GITMO. outcome of allogeneic hematopoietic stem cell transplantation in adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia in the era of tyrosine kinase inhibitors: A Registry-based study of the Italian Blood and Marrow Transplantation Society (GITMO). Biol Blood Marrow Transplant. 2019;25: 2388-97.

Duong HK, Savani BN, Copelan E, Devine S, Costa LJ , Wingard JR, Shaughnessy P, et al. Peripheral blood progenitor cell mobilization for autologous and allogeneic hematopoietic cell transplantation: guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2014;20:1262-73.

Gambell P, Herbert K, Dickinson M, Stokes K, Bressel M, Wall D, et al. Peripheral blood CD34+ cell enumeration as a predictor of apheresis yield: An analysis of more than 1,000 collections. Biol Blood Marrow Transplant. 2012;18:763–72.

Del Fante C, Perotti C, Viarengo G, Bellotti L, Parisi C, Marchesi A, et al. Clinical impact of a new automated system employed for peripheral blood stem cell collection. J Clin Apher. 2006;21:227–32.

Kriegsmann K, Wack M, Pavel P, Schmitt A , Kriegsmann M, Bruckner T, et al. Collection, cryostorage, transplantation, and disposal of hematopoietic stem cell products. Biol Blood Marrow Transplant. 2019;25:382-90.

Sawant RB, Rajadhyaksha SB. Correlation of CD34+ cell yield in peripheral blood progenitor cell product with the pre-leukapheresis cell counts in peripheral blood. J Assoc Physicians India. 2005; 53:1031–5.

Sarkodee-Adoo C, Taran I, Guo C, Buadi F, Murthy R, Cox E, et al. Influence of preapheresis clinical factors on the efficiency of CD34+ cell collection by large-volume apheresis. Bone Marrow Transplant. 2003;31:851–5.

Ford CD, Chan KJ, Reilly WF, Petersen FB. An evaluation of predictive factors for CD34+ cell harvest yields from patients mobilized with chemotherapy and growth factors. Transfusion. 2003;43: 622–5.

Ahmed SOA, Ghavamzadeh A, Zaidi SZ, Baldomero H, Pasquini MC, Hussain F, et al. Trends of hematopoietic stem cell transplantation in the Eastern Mediterranean region, 1984–2007. Biol Blood Marrow Transplant. 2011;17: 1352–61.

Mijovic A, Derwood Pamphilon D. Harvesting, processing and inventory management of peripheral blood stem cells. Asian J Transfus Sci. 2007;1: 16–23.

Juric MK, Ghimire S, Ogonek J, Weissinger EM, Holler E, van Rood JJ, et al. Milestones of hematopoietic stem cell transplantation – From first human studies to current developments. Front Immunol. 2016;7:470-7.

Tanaka H, Ishii A, Sugita Y, Shimizu R, Sato F, Sakuma Y, et al. Impact of Hematopoietic progenitor cell count as an indicator for optimal timing of peripheral stem cell harvest in clinical practice. J Clin Exp Hematop. 2017; 56:150–9.

de Almeida-Neto C, Rocha V, Moreira FR, Hamasaki DT, de Farias MC, Arrifano AM, et al. Validation of a formula predictive of peripheral blood stem cell yield and successful collection in healthy allogeneic donors. Hematol Transfus Cell Ther. 2020;42:164–5.

Mueller BU, Seipel K, Bacher U, Pabst T. Autologous transplantation for older adults with AML. Cancers (Basel). 2018;10:340-9.

Accorsi P, Passeri C, Iacone A. A multiple regression analysis on factors influencing haematopoietic progenitor cell collection for autologous transplantation. Transfus Apher Sci. 2012;47:223-7.

Hsu YM, Cushing MM. Autologous Stem Cell Mobilization and Collection. Hematol Oncol Clin North Am. 2016;30:573-89.

Movassaghi K, Jaques G, Schmitt-Thomssen A, Fischer EG, Paulus M, Heuft HG, et al. Evaluation of the COM.TEC cell separator in predicting the yield of harvested CD34+ cells. Transfusion. 2007;47:824–31.

Heuft HG, Dubiel M, Kingreen D, Oertel J, De Reys S, Rick O, et al. Automated collection of peripheral blood stem cells with the COBE Spectra for autotransplantation. Vox Sang. 2000;79: 94–9.

Lee SN, Sohn JY, Kong JH, Eom HS, Lee H, Kong SY. Comparison of two apheresis systems of COBE and Optia for autologous peripheral blood stem cell collection. Ann Lab Med. 2017;37:327-30.

Sutherland DR, Anderson L, Keeney M, Nayar R, Chin-Yee I. The ISHAGE guidelines for CD34+ cell determination by flow cytometry. International Society of Hematotherapy and Graft Engineering. J Hematother. 1996; 5:213–26.

Dima F, Barison E, Midolo M, Benedetti F, Lippi G. Assessment of haematopoietic progenitor cell counting with the Sysmex XN-1000 to guide timing of apheresis of peripheral blood stem cells. Blood Transfus. 2020;18:67-76.

Neyrinck MM , Vrielink H, Joint Task Force for Education and Certification. Calculations in apheresis. J Clin Apher. 2015;30:38-42.

Setia RD, Arora S, Handoo A, Choudhary D, Sajeev Kumar Sharma SK, Dadu T, et al. Comparison of “Amicus and COBE Spectra” for autologous peripheral blood stem cell harvest: An Indian experience. Glob J Transfus Med. 2017; 2:102-8.

Mathur G, Bell SL, Collins L, Nelson GA, Knudson CM, Schlueter AJ. Factors influencing platelet clumping during peripheral blood hematopoietic stem cell collection. Transfusion. 2017;57:1142–51.

Hsu JW , Shaw BE, Kim S, Logan BR, Sees JA , Confer DL, et al. Collection of Peripheral blood progenitor cells in one day is associated with decreased donor toxicity compared to two days in unrelated donors. Biol Blood Marrow Transplant. 2020; 26: 1210–17.

Altuntas F, Kocyigit I, Ozturk A, Kaynar L, Sari I, Oztekin M, et al. Comparison of the Fenwal Amicus and Fresenius Com. Tec cell separators for autologous peripheral blood progenitor cell collection. Transfus Apher Sci. 2007;36:159-67.

Deneys V, Fabry A, Van Hooydonk M , Sonet A , Marc André M , Bourgeois M , et al. Efficiency of autologous stem cell collection: Comparison of three different cell separators. Transfus Apher Sci. 2017;56:35-8.

Rowley SD, Prather K, Bui KT, Appel M, Felt T, Bensinger WI. Collection of peripheral blood progenitor cells with an automated leukapheresis system. Transfusion. 1999;39:1200-6.

Hitzler WE, Wolf S, Runkel S, Kunz-Kostomanolakis M. Comparison of intermittent- and continuous-flow cell separators for the collection of autologous peripheral blood progenitor cells in patients with hematologic malignancies. Transfusion. 2001;41:1562-6.

Adorno G, Del Proposto G, Palombi F, Bruno A, Ballatore G, Postorino M, et al. Collection of peripheral progenitor cells: a comparison between Amicus and Cobe-Spectra blood cell separators. Transfus Apher Sci. 2004;30: 131-6.

Coluccia P, Montefusco V, Tunesi S, Avella M, Bompadre A, Longoni P, et al. 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. J Clin Apher. 2009;24:134-40.

Cooling L, Hoffmann S, Herrst M, Muck C, Armelagos H, Davenport R. A prospective randomized trial of two popular mononuclear cell collection sets for autologous peripheral blood stem cell collection in multiple myeloma. Transfusion. 2010;50:100-19.

Cousins AF, Sinclair JE, Alcorn MJ, H A Green R, Douglas KW. HPC-A dose prediction on the Optia cell separator based on abenchmark CE2 collection efficiency: Promoting clinical efficiency, minimizing toxicity, and allowing quality control. J Clin Apher. 2015;30:321-8.

Wuchter P, Hundemer M, Schmitt A, Witzens-Harig M, Pavel P, Hillengass J, et al. Performance assessment and benchmarking of autologous peripheral blood stem cell collection with two different apheresis devices. Transfus Med. 2017;27: 36-42.

Sanderson F, Poullin P, Smith R, Nicolino-Brunet C, Philip P, Chaib A, 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 Apher. 2017; 32:182-90.

Lisenko K, Pavel P, Bruckner T, Puthenparambil J, Hundemer M, Schmitt A. Comparison between intermittent and continuous Spectra Optia leukapheresis systems for autologous peripheral blood stem cell collection. J Clin Apher. 2017;32:27-34.

Solmaz S, Kahraman S, Sevindik OG, Acar C, Turkyilmaz M, Alacacioglu I, et al. A comparison of Fresenius Com.Tec cell and Spectra Optia cell separators for autologous and allogeneic stem cell collections: Single center experience. Indian J Hematol Blood Transfus. 2018;34:677-83.

Pandey S, Cottler-Fox M. Optia continuous mononuclear collection (CMNC) system is a safe and efficient system for hematopoietic progenitor cells-apheresis (HPC-a) collection and yields a lower product hematocrit (HCT%) than the COBE Spectra system: A retrospective study. J Clin Apher. 2018;33:505-13.

Bojanic I, Besson N, Vidovic I, Cepulic BG. Performance prediction algorithm for autologous PBSC collection in adults and pediatric patients using large volume leukapheresis. J Clin Apher. 2019;34: 407-15.

López-Pereira P, Sola Aparicio E, Vicuña Andrés I, Cámara Montejano C, Muñoz Calleja C, Alegre Amor A, et al. Retrospective comparison between Cobe Spectra and Spectra Optia apheresis systems for hematopoietic progenitor cells collection for autologous and allogeneic transplantation in a single center. J Clin Apher. 2020;35:453-9.

Chung Y, Kong JH, Hu Y, Lee S-N, Shim H , Eom H-S, et al. Comparison of Spectra Optia and Amicus cell separators for autologous peripheral blood stem cell collection. J Clin Apher. 2021;36:28-33.

Lane TA, Bashey A, Carrier E, Holman P, Castro J, Mullen M, et al.. Improving the efficiency of PBPC collection by pre-apheresis peripheral blood and mid-apheresis product measurements of CD34 cells. Cytotherapy. 2004;6(4):318-27.

Lemos NE, Farias GF, Kubaski F, Scotti L, Onsten TGH, de Almeida Brondani L, et al. Quantification of peripheral blood CD34+ cells prior to stem cell harvesting by leukapheresis: a single center experience. Hematol Transfus Cell Ther. 2018;40:213–8.

Malachowski R, Grzybowska-Izydorczyk O, Szmigielska-Kapłon A, Brzozowski K, Nowicki M, Zieliński K, et al. Comparison of prediction models for two different peripheral stem cell collection protocols in autologous patients: How to avoid errors in calculating total blood volume to process? Acta Haematol Pol. 2021;52:38–47.

Ali S, Chiang KY, Even-Or E. Comparison between intermittent and continuous leukapheresis protocols for autologous hematopoietic stem cell collections in children. J Clin Apher 2019;30:646-55.

Kindwall-Keller T. Peripheral stem cell collection: from leukocyte growth factor to removal of catheter. J Clin Apher. 2014; 29:199-205.

Neyrinck MM, Vrielink H; Joint Task Force for Education and Certification.Calculations in apheresis. J Clin Apher. 2015;30(1):38-42.

Verlinden A, Van de Velde A, Verpooten GA, Janssen van Doorn K. Determining factors predictive of CD34+ cell collection efficiency in an effort to avoid extended and repeated apheresis sessions. J Clin Apher. 2013;28(6):404-10.

Filonenko K, Zarutska V, Martynchyk A, Kushchevyi Y, Stepanishyna Y, Kriachok I. Comparison of the efficiency of peripheral blood stem cell apheresis on the blood cell separators. Klin Onkol. 2022;35(6):448-453.

Ono Y, Yoshioka S, Inoue K, Yoshida M, Maruoka H, Ishikawa T. Stochastic model based on preharvest peripheral CD34-positive cell count and collection efficiency predicting processed blood volume in peripheral hematopoietic stem cell apheresis. Transfusion. 2019;59(2):671-680.

Cid J, Castillo C, Marín P, Carbassé G, Herrera D, Monfort N, et al. Increased collection efficiency of CD34+ cells after mobilization with preemptive use of plerixafor followed by leukocytapheresis on the same day. Transfusion. 2020;60(4):779-785.

Schwella N, Movassaghi K, Scheding S, Ahrens N, Salama A. Comparison of two leukapheresis programs for computerized collection of blood progenitor cells on a new cell separator. Transfusion. 2003;43:58–64.

Mehta J, Oyama Y, Winter J, Williams S, Tallman M, Singhal S, et al. CD34(+) cell collection efficiency does not correlate with the pre-leukapheresis hematocrit. Bone Marrow Transplant. 2001; 28:597–601.

Jeanne M, Bouzgarrou R, Lafarge X, Fizet D, Dazey B, Vezon G, et al. Comparison of CD34+ cell collection on the CS-3000+ and Amicus blood cell separators. Transfusion. 2003;43:1423–7.

Matic GB, Ullrich H, Barlage S, Rothe G, Schmitz G. Effect of processed blood volume, leukocyte count and concentration of CD34-positive cells in peripheral blood on efficiency of stem cell apheresis. Beitr Infusionsther Transfusionsmed. 1997;34: 139–43.

Reinhardt P, Brauninger S, Bialleck H, Thorausch K, Smith R, Schrezenmeier 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: 1321‑30.

Ikeda K, Kozuka T, Harada M. Factors for PBPC collection efficiency and collection predictors. Transfus Apher Sci. 2004;31: 245–59.

Movassaghi K, Jaques G, Schmitt-Thomssen A, Fischer EG, Paulus M, Heuft HG, et al. Evaluation of the COM.TEC cell separator in predicting the yield of harvested CD34+ cells. Transfusion. 2007;47:824-31.

Fontana S, Groebli R, Leibundgut K, Pabst T, Zwicky C, Taleghani BM. Progenitor cell recruitment during individualized high-flow, very-large-volume apheresis for autologous transplantation improves collection efficiency. Transfusion. 2006; 46:1408-16.

Moller AK, Dickmeiss E, Geisler CH, Christensen LD. Recruitment of CD34+ cells during large-volume leukapheresis. J Hematother Stem Cell Res. 2001;10(6): 837-53.