PBPC collections: Management, techniques and risks.

Area of Science:

• Hematology
• Oncology
• Cellular Therapy

Background:

• Autologous peripheral blood progenitor cell (PBPC) collection is crucial for hemato-oncological disease treatment.
• Standard and large-volume leukapheresis (LVL) are common PBPC collection methods, but may not be suitable for all patients.
• Patient intolerance to citrate or procedure extent necessitates alternative collection techniques.

Purpose of the Study:

• To evaluate the efficiency, safety, and risks of three autologous PBPC collection techniques: LVL, standard, and a novel 'Mixed' collection method.
• To identify a safe and effective collection technique for patients who cannot tolerate standard or LVL procedures.

Main Methods:

• A comparative study of 136 autologous PBPC collections in 98 hemato-oncological patients.
• Three techniques were assessed: 93 LVL (processing >3 total blood volumes, ACD-A + Heparin), 16 Standard (<3 TBV, ACD-A), and 27 'Mixed' (<3 TBV, ACD-A + Heparin).
• Collections were performed using a Cobe Spectra separator.

Main Results:

• LVL yielded significantly more CD34+ cells (8.2x10^6/kg) compared to Standard (0.9x10^6/kg) and 'Mixed' (1.2x10^6/kg) in weakly mobilized patients.
• In well-mobilized patients, LVL also showed a higher median yield (8.2x10^6/kg) versus Standard (3.8x10^6/kg) and 'Mixed' (4x10^6/kg).
• All procedures were well-tolerated; only 3 of 22 adverse reactions were procedure-related (mild hypocalcemia, hypotension).

Conclusions:

• LVL is recommended for patients who can tolerate it, offering a higher yield of CD34+ cells, especially beneficial for weakly mobilized patients.
• The 'Mixed' collection technique serves as a viable alternative for patients intolerant to high citrate doses or extensive procedures.
• The study identified 'Mixed' collections as a safe and efficient option for specific patient populations undergoing PBPC collection.