Non-cryopreserved peripheral blood progenitor cells collected by a
single very barge-volume leukapheresis: A simplified and effective
procedure for support of high-dose chemotherapy
High-dose chemotherapy with autologous peripheral brood progenitor cell
(PBPC) support has become a widely used treatment strategy. In order to
simplify the procedure, a single very large-volume leukapheresis
programme combined with short-term refrigerated storage of the PBPC was
developed. Seventy-two patients suffering from various relatively
chemosensitive malignancies received high-dose chemotherapy, consisting
of agents with short in vivo half-lives and 24 to 48 hours Later, the
refrigerated PBPC were reinfused. A single very large-volume apheresis
was sufficient to obtain at least 2 x 10(6)/kg CD34+ cells in 58
patients (81%), and 63% had at least 2.5 x 10(6) CD34+ cells/kg. Only
two patients (3%) were transplanted with less than 1 x 10(6) CD34+
cells/kg. In three patients (4%) leukapheresis was repeated because of
insufficient number of PBPC. The median CD34+ cell count was 3 x
10(6)/kg. A median of 38.5 L blood (range, 21 to 59) was processed,
which accounted for a median of 9 x patient’s total blood volume. Very
large-volume leukapharesis was well tolerated with symptomatic
hypocalcemia being the most common (18%) side-effect. The median time
to neutrophils >1.5 x 10(9)/L, and to self-supporting platelet count >25
x 10(9)/L, was 10 and 12 days after reinfusion of PBPC graft,
respectively. There were no treatment-related deaths. Our results
indicate that this simplified approach of PBPC transplantation can be
associated with prompt hematologic recovery in most patients and that it
can be useful in settings where facilities are limited or for certain
diseases where conditioning regimens with shea half-life are
appropriate. J. Clin. Apheresis, 15:236-241, 2000. (C) 2000 Wiley-Liss,
Inc
