Background: A convenient, effective and safe peripheral blood stem cell (PBSC) apheresis procedure is desirable to cope with the increasing requirements for PBSC collections. We performed PBSC harvesting with the novel COBE Spectra AutoPBSCTM system using the default software configuration recommended by the manufacturer. We analyzed collection parameters and clinical efficiency of harvested autografts following high-dose chemotherapy (HDCT). Patients and Methods: Eighty-one patients underwent 102 harvests after standard chemotherapy plus filgrastim (5–10 μg/kg/day) to obtain a target of ≥2.5 × 106 CD34+ cells/kg for autologous blood stem cell transplantation. Conventional-volume leukaphereses (median: 11 liters) were performed using the manufacturer’s standard software default regarding inlet flow, harvest/chase volume (3/7 ml) and number of collection cycles. The ratio of ACD-A to whole blood was initially set at 1:12 (56 collections), later at 1:10 (46 aphereses). Results: With respect to preapheresis counts of 93 (9–876) CD34+ cells/μl, 69 patients (85.2%) achieved ≥2.5 × 106 CD34+ cells/kg by the first apheresis. PBSC products contained medians of 5.0 × 106 (0.7–77.3) CD34+ cells/kg and 13.8 × 104 (2.3–105.0) CFU-GM/kg. A preapheresis count of ≥40 CD34+ cells/μl predicted a single-apheresis yield of ≥2.5 × 106 CD34+ cells/kg. Apheresis products showed a high mononuclear cell (MNC) purity of ≥89%. The median overall collection efficiency of CD34+ cells (CD34-CE) was 42.6% (12.2–87.4). The CD34-CE decreased significantly with increasing numbers of circulating CD34+ cells: 52.5% at CD34+ cells <40/μl versus 41.0% at CD34+ cells ≥40/μl (p ≤ 0.002). Coagulation problems occurred in 3 of 56 procedures at an ACD-A to whole blood ratio of 1:12, but in no case at 1:10. Patients who underwent HDCT and autologous blood stem cell transplantation (n = 40) engrafted in a median time of 9 (8–13) days for absolute neutrophil counts >0.5 × 103/μl, 10 (8–13) days for WBC >1.0 × 103/μl and 11 (8–17) days for platelets >20 × 103/μl. Conclusions: As a result of efficient PBSC mobilization, a single conventional-volume leukapheresis with the COBE Spectra AutoPBSC system resulted in hematopoietic autografts with ≥2.5 × 106 CD34+ cells/kg in 85% of patients. Following the standard PBSC apheresis recommendations of the manufacturer, the AutoPBSC system assures PBSC products with a high MNC purity and a moderate CD34-CE that declines significantly at increasing levels of circulating CD34+ cells. Leukaphereses performed at an ACD-A to whole blood ratio of 1:10 should run without coagulation problems.

Keywords:
Peripheral blood stem cell apheresis, AutoPBSC system, Collection efficiency, Autotransplantation, Hematopoietic recovery
1.
Williams SF, Bitran JD, Richards JM, DeChristopher PJ, Barker E, Conant J, Golomb HM, Orlina AR: Peripheral blood-derived stem cell collections for use in autologous transplantation after high-dose chemtherapy: An alternative approach. Bone Marrow Transplant 1990;5:129–133.
2.
To LB, Roberts MM, Haylock DN, Dyson PG, Branford AL, Thorp D, Ho JQ, Dart GW, Horvath N, Davy ML: Comparison of hematological recovery times and supportive care requirements of autologous recovery phase peripheral blood stem cell transplants, autologous bone marrow transplants and allogeneic bone marrow transplants. Bone Marrow Transplant 1992;9:277–284.
3.
Beyer J, Schwella N, Zingsem J, Strohscheer I, Schwaner I, Oettle H, Serke S, Huhn D, Siegert W: Hematopoietic rescue after high-dose chemotherapy using autologous peripheral-blood progenitor cells or bone marrow: A randomized comparison. J Clin Oncol 1995;13:1328–1335.
4.
Ross AA, Cooper BW, Lazarus HM, Mackay W, Moss TJ, Ciobanu N, Tallman MS, Kennedy MJ, Davidson NE: Detection and viability in peripheral blood stem cell collections from breast cancer patients using immunocytochemical and clonogenic assay techniques. Blood 1993;82:2605–2610.
5.
Miyajima Y, Horibe K, Fukuda M, Matsumoto K, Numata S, Mori H, Kato K: Sequential detection of tumor cells in the peripheral blood and bone marrow of patients with stage IV neuroblastoma by the reverse transcription-polymerase chain reaction for tyrosine hydroxylase mRNA. Cancer 1996;77:1214–1219.
6.
Shea TC, Mason JR, Breslin M, Bissent E, Mullen M, Taetle R: Reinfusion and serial measurements of carboplatin mobilized peripheral blood progenitor cells in patients receiving multiple cycles of high dose chemotherapy. J Clin Oncol 1994;12:1012–1020.
7.
Silvestri F, Fritsch G, Serke S, Sovalat H, Wunder E: Comparison of two monoclonal antibodies – 8G12 and QBEND10 – in detecting CD34+ circulating cells in the peripheral blood. Eur J Lab Med 1993;1:125–128.
8.
Schwella N, Beyer J, Schwaner I, Heuft HG, Rick O, Huhn D, Serke S, Siegert W: Impact of preleukapheresis cell counts on collection results and correlation of progenitor cell dose with engraftment after high dose chemotherapy in patients with germ cell cancer. J Clin Oncol 1996;14:1114–1121.
9.
Bambi F, Faulkner LB, Azzari C, Gelli AMG, Tamburini A, Tintori V, Lippi A, Tucci F, Bernini G, Genovese F: Pediatric peripheral blood progenitor cell collection: Haemonetics MCS 3P versus COBE Spectra versus Fresenius AS104. Transfusion 1998;38:70–74.
10.
Pierelli L, Menichella G, Paolini A, Vittori M, Foddai ML, Serafini R, Rumi C, Mitschulat H, Rossi PL, Scambia G, Teofili L, Sica S, Leone G, Bizzi B: Evaluation of a novel automated protocol for the collection of peripheral blood stem cells mobilized with chemotherapy or chemotherapy with G-CSF using the Fresenius AS104 cell separator. J Hematother 1993;2:145–153.
11.
Dziezckowski JS, McConigal M, Cook J, Sugrue M, Andersen J, Andersen KC: A comparison of peripheral blood stem cell apheresis using the Fenwal CS3000 Plus and Cobe Spectra. Transfus Sci 1995;16:71–77.
12.
Tricot G, Jagannath S, Vesole D, Nelson J, Tindle S, Miller L, Cheson B, Crowley J, Barlogie B: Peripheral blood stem cell transplants for multiple myeloma: Identification of favourable variables for rapid engraftment in 225 patients. Blood 1995;85:588–596.
13.
Haas R, Möhle R, Frühauf S, Goldschmidt H, Witt B, Flentje J, Wannenmacher M, Hunstein W: Patient characteristics associated with successful mobilizing and autografting of peripheral blood progenitor cells in malignant lymphoma. Blood 1994;83:3787–3794.
14.
Bensinger W, Appelbaum F, Rowley S, Storb R, Sanders J, Lilleby K, Gooley T, Demirer T, Schiffman K, Weaver C, Clift R, Chauncey T, Klarnet J, Montgomery P, Petersdorf S, Weiden P, Witherspoon R, Buckner CD: Factors that influence collection and engraftment of autologous peripheral-blood stem cells. J Clin Oncol 1995;13:2547–2555.
15.
Weaver CH, Hazelton B, Birch R, Palmer P, Allen C, Schwartzberg L, West W: An analysis of engraftment kinetics as a function of the CD34 content of peripheral blood progenitor cell collections in 692 patients after the administration of myeloablative chemotherapy. Blood 1995;86:3961–3969.
16.
Remes K, Matinlauri I, Grenman S, Itala M, Kauppila M, Pelliniemi TT, Salminen E, Vanharanta R, Rajamaki A: Daily measurements of blood CD34+ cells after stem cell mobilization predict stem cell yield and posttransplant platelet recovery. J Hematother 1997;6:13–19.
17.
Ravagnani F, Siena S, De Reys S, Di Nicola M, Notti P, Giardini R, Bregni M, Matteucci P, Gianni AM, Pellegris G: Improved collection of mobilized CD34+ hematopoietic progenitor cells by a novel automated leukapheresis system. Transfusion 1999;39:48–55.
18.
Schreiner T, Wiesneth M, Krug E, Kalinova J, Büchele H, Maccari B, Erne E, Bischof C, De Reys S: Collection of allogeneic peripheral blood progenitor cells by two protocols on an apheresis system. Transfusion 1998;38:1051–1055.
19.
Stroncek DF, Clay ME, Smith J, Jaszcz WB, Herr G, Mc Cullough J: Comparison of two blood cell separators in collecting peripheral blood stem cell components. Transfus Med 1997;7:95–99.
20.
Morton JAP, Baker DP, Hutchins CJ, Durrant STS: The Cobe Spectra cell separator is more effective than the Haemonetics MCS-3P cell separator for peripheral blood progenitor cell harvest after mobilization with cyclophosphamide and filgrastim. Transfusion 1997;37:631–633.
21.
Menichella G, Lai M, Pierelli L, Vittori M, Serafini R, Ciarli M, Foddai ML, Salerno G, Sica S, Scambia G, Leone G, Bizzi B: Evaluation of two different protocols for peripheral blood stem cell collection with the Fresenius AS 104 blood cell separator. Vox Sang 1997;73:230–236.
22.
Murea S, Goldschmidt H, Hahn U, Pförsich M, Moos M, Haas R: Successful collection and transplantation of peripheral blood stem cells in cancer patients using large volume leukapheresis. J Clin Apheresis 1996;11:185–194.
23.
Hillyer CD, Tiegerman KO, Berkman EM: Increase in circulating colony-forming units granulocyte-macrophage during large-volume leukapheresis: Evaluation of a new cell separator. Transfusion 1991;31:327–332.
24.
Chong BH: Heparin induced thrombocytopenia. Br J Haematol 1995;89:431–439.
© 2000 S. Karger AG, Basel
2000
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.