A. Santoro

G. Moroni

I. Timofeeva

K. Granzow

R. Schiavo

S. Siena

AIR Universita degli studi di Milano

752
Haematologica vol. 84(8):August 1999
Scientific correspondence
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New technology and changing parameters of
leukapheresis for blood cell transplantation
Sir,
Clinical investigators have recently developed an innova-
tive technique of leukapheresis (LK) for blood cell trans-
plantation (BCT) referred to as AutoPBSC System. This
technique offers the following advantages: a) better collec-
tion efficiency of CD34+ hematopoietic progenitor cells; b)
reduced collection of platelets; c) higher quality of LK com-
ponents in terms of reduced contamination by granulo-
cytes, platelets, and erythrocytes; d) reduced LK volume;
and e) automation.1 These advantages prompted us to eval-
uate the effectiveness of the AutoPBSC System and to
extend classic parameters for starting LK, i.e., CD34+ cells
‡ 20/µL and platelets ‡ 303103/µL,2 also to poor-mobiliz-
er and/or thrombocytopenic patients, i. e., with CD34+ cells
≤ 20/µL and/or platelets ≤ 303103/µL, respectively. We
confirm the advantages of the AutoPBSC System and
demonstrate that efficient LK can successfully be performed
also in these categories of patients.
Ninety-six leukaphereses were carried out in 65 consecu-
tive patients undergoing BCT for treatment of poor progno-
sis malignancies (13 multiple myeloma, 12 breast cancer, 8
Ewing’s sarcoma family of tumors, 9 non-Hodgkin’s lym-
phoma, 7 Hodgkin’s disease, 6 ovarian cancer, 3 rhab-
domyosarcoma, 3 desmoplastic small cell tumor, 1 Wilms’
tumor, 2 non-small cell lung cancer, 1 yolk sac tumor). The
LK procedure implied processing 2.5-fold the individual’s
blood volume and adaptation of the AutoPBSC software
default and harvest frequency as described by Ravagnani et
al.1 At the time of LK, the mean CD34+ cell count per µL was
106, the median 53, and the range 3-626; mean platelet
count was 1043103 µL, median 923103, range 15-4563103.
As detailed in Figure 1, the collection target of CD34+
cells ‡ 53106 in a single LK was achieved in 100% (48/48)
of procedures when the initial CD34+ cells ‡ 50/µL and 21%
(10/48) when CD34+ cells ≤ 50/µL. Single LK in poor-mobi-
lizer patients (n = 17) with CD34+ cell counts >10/µL and
≤20/µL (n=14) and ≤10/µL (n=15) yielded mean 2.13106,
median 1.8, range 0.7-3.73106 and mean 1.73106 CD34+
cells/kg, median 1.7, range 0.8-3.43106, respectively; in
thrombocytopenic patients (n = 7) a single LK yielded mean
3.93106 CD34+ cells/kg, median 2.6, range 0.8-14.63106;
and in thrombocytopenic and poor-mobilizer patients (n =
5) it yielded mean 1.93106 CD34+ cells/kg, median 1.8,
range 0.8-3.13106. Although platelet depletion in throm-
bocytopenic patients was negligible, a prophylactic platelet
transfusion was given after LK to 3 patients.
Results of a single leukapheresis presented here compare
favorably with those previously attained with other tech-
niques1,2 and confirm for the first time the advantages of the
AutoPBSC System in poor-mobilizer and thrombocytopenic
patients as well, thus facilitating the clinical application of
blood cell transplantation.
Katharina Granzow,*  Roberta Schiavo,° Inna Timofeeva,°
Gianalessandro Moroni,*  Armando Santoro,° Salvatore Siena°
*Servizio di Immunoematologia e Medicina Trasfusionale,
Ospedale San Paolo, Milan; °Department of Oncology and
Hematology and Section of Blood and Marrow Transplantation,
Istituto Clinico Humanitas, Rozzano (MI), Italy
Key words
Leukapheresis, blood cell transplantation, CD34+ cells
Correspondence
Salvatore Siena, Divisione Oncologia Medica Falck, Ospedale
Niguarda-Ca’ Granda, piazza Ospedale Maggiore 3, 20162
Milan, Italy. Phone international +39.02.64442991 – Fax.
international +39.02.64442910 – E-mail: salsiena@tin.it
References
1. Ravagnani F, Siena S, De Reys S, et al. Improved col-
lection of mobilized CD34+ hematopoietic progenitor
cells by a novel automated leukapheresis system.
Transfusion 1999; 39:48-55.
2. Moog R, Muller N. Technical aspects and perfor-
mance in collecting peripheral blood progenitor cells.
Ann Hematol 1998; 77:143-7.
Figure 1. Yields of CD34+ progenitor cells by single LK ver-
sus CD34+ cell counts. Data shown are limited to the 48
procedures with CD34+ cells ≤50/µL (total LK=96).


New technology and changing parameters of leukapheresis for blood cell transplantation

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New technology and changing parameters of leukapheresis for blood cell transplantation

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