Alternate dosage regimens for high-molecular-weight hydroxyethyl starch

Area of Science:

• Hematology
• Transfusion Medicine

Background:

• Granulocyte collection relies on specific reagents to enhance yields.
• High-molecular-weight hydroxyethyl starch (HES) is commonly used in leukapheresis procedures.
• Optimizing HES dosage is crucial for efficient granulocyte procurement.

Purpose of the Study:

• To evaluate the efficacy of reduced dosage regimens of 6% HES for granulocyte procurement.
• To determine the optimal timing and concentration of HES administration during leukapheresis.
• To compare yields obtained with standard versus modified HES protocols.

Main Methods:

• Leukapheresis procedures were performed using standard 500-ml doses of 6% HES.
• Alternate regimens included reduced HES doses, altered administration timing, and use of acid-citrate-dextrose, Formula-A (ACD-A).
• Granulocyte yields were quantified per liter of blood processed (LBP) and compared across different HES protocols.

Main Results:

• Standard 500-ml HES doses yielded 0.57 x 10(10) granulocytes/LBP.
• Reduced HES doses or administration solely in initial passes significantly lowered yields (e.g., 0.14-0.35 x 10(10) granulocytes/LBP).
• Pre-procedure HES infusion was ineffective, underscoring the need for HES presence during centrifugation.

Conclusions:

• Alternate dosage regimens of 6% HES are not advisable for granulocyte procurement.
• Optimal granulocyte yields are achieved with the standard 500-ml dose of 6% HES during the collection procedure.
• HES must be administered during centrifugation and separation to maximize yields.