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Therapeutic cytapheresis: continuous flow versus intermittent flow apheresis systems
1Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Clinical Apheresis
|January 1, 1994
Summary
Continuous flow (CF) systems showed lower platelet reduction during therapeutic plateletapheresis (TP) but comparable white blood cell removal in therapeutic leukapheresis (TL) compared to intermittent flow (IF) systems. CF also resulted in less hemoglobin loss and lower adverse reaction rates.
Area of Science:
- Hematology
- Medical Technology
- Apheresis
Background:
- Therapeutic apheresis, including plateletapheresis (TP) and leukapheresis (TL), is crucial for managing various hematological conditions.
- Continuous flow (CF) and intermittent flow (IF) apheresis systems differ in their operational mechanisms, potentially impacting procedural efficiency and patient outcomes.
Purpose of the Study:
- To compare the performance of continuous flow (CF) and intermittent flow (IF) apheresis systems in therapeutic plateletapheresis (TP) and therapeutic leukapheresis (TL).
- To evaluate differences in cell reduction, specificity of removal, volumes processed, and adverse reaction incidence between CF and IF systems.
Main Methods:
- A retrospective study comparing two apheresis systems: COBE Spectra (CF) and Haemonetics V-50, M-30 (IF).
- Analysis included 49 patients for TP and 29 patients for TL, comparing pre- and post-procedure parameters.
- Standard procedures with minor modifications were used, with starch utilized only in the IF system, and a fixed blood processing time of 180 minutes.
Main Results:
- CF systems demonstrated significantly lower platelet reduction during TP (43% vs. 53% for IF) but comparable white blood cell reduction during TL (49% vs. 42% for IF).
- CF systems resulted in significantly less hemoglobin and white blood cell reduction during TP, and less hemoglobin and platelet reduction during TL compared to IF.
- CF systems removed significantly lower volumes of blood during both TP and TL and exhibited a lower incidence of adverse reactions in both procedures.
Conclusions:
- Continuous flow apheresis systems offer comparable efficacy to intermittent flow systems for therapeutic leukapheresis while demonstrating advantages in reduced hemoglobin loss, lower cell loss, and fewer adverse events during both therapeutic plateletapheresis and leukapheresis.
- CF systems may be preferable due to their improved safety profile and reduced impact on patient's red blood cell mass.