Performance of a new separator system for routine autologous hematopoietic progenitor cell collection in small...

The AMICUS system was recently introduced for peripheral blood stem cell (PBSC) aphereses in adults. We conducted a single center field evaluation to obtain data about the performance of this system in children with a body weight (bw) < 25 kg. Results of blood priming procedures were compared to historical data obtained with the Fenwal CS3000+ (CS 3000). From August, 2001 to February, 2007, 47/178 (26%) PBSC aphereses procedures were performed in our institution with the AMICUS system in 35 small patients (median bw 13.9 kg; range 6.7-24; age 2.78 years; range 0.97-7.06). The patients suffered from various malignant primary diseases or recurrences. We primed the system with packed RBC in case of >30% dilution of the RBC volume (n = 31) or with saline (n = 16). Compared to the CS3000, the AMICUS revealed comparable collection efficiencies (CE) for CD34+ cells (median 67%, range 26-120), lymphocytes (75%, 25-138), monocytes (54%, 23-173), and granulocytes (10%, 1.5-36), MNC (57% 24-125), but a significantly higher erythrocyte and granulocyte, and a lower platelet CE. There was a significant negative correlation between total leukocyte count and CE for MNC (r = -0.566; P < 0.001) and CD34+ cells (r = -0.517; P < 0.001). There was no significant statistical or clinical difference between the CE in blood-primed procedures and saline-primed procedures. With the AMICUS we saw statistically less citrate reactions compared to the CS 3000. We conclude that the AMICUS system is safe and efficient to harvest PBSC on a routine basis in pediatric patients, even in children < or =10 kg bw.