摘要:

AbstractApheresis procedures that optimize peripheral blood stem cell (PBSC) harvesting also result in a significant loss of platelets to the patient/donor because of their similar densities. We compared the percent drop in platelet count and hemoglobin concentration in the patients before and after PBSC collection using two different collection chambers with the CS‐3000TM. A modified plateletpheresis procedure was utilized. Seven patients underwent 38 PBSC collections during steady state hematopoiesis using the standard A‐35 collection chamber. At the end of the procedure, a second low‐speed centrifugation of the PBSC concentrate was performed in the manual mode, with siphoning out and return of the PRP to the patient through a transfer pack. For 14 patients who underwent 113 PBSC collections, a small volume collection chamber (SVCC) was substituted for the A‐35 chamber and the second centrifugation step was omitted. These patients were also primed with 4 g/m2of cyclophosphamide. The percent drop in platelet count in the patients after the collection procedures was significantly less in the SVCC group (20.4 ± 9.1 vs. 36.0 ± 12.3,P= 0.000), even after correction for the difference in the volume of blood processed between the two groups (3.2 ± 1.4 vs. 3.9 ± 1.3,P= 0.006). The percent drop in hemoglobin concentration was also less with the SVCC both before (5.4 ± 3.8 vs. 11.7 ± 3.0,P= 0.000) and after (0.8 ± 0.6 vs. 1.3 ± 0.3,P= 0.000) correction for the difference in the volume of blood processed. The cellular contents of the PBSC concentrates were similar in both groups although mononuclear cell (MNC) purity was slightly higher in the A‐35 group (95.6 ± 5.9% vs. 91.0 ± 13.0%,P= 0.037). The MNC extraction efficiency was similar with both collection chambers (60.2 ± 17.4% for the SV and 64.6 ± 18.5% for the A‐35). The advantages of the SVCC and the possible reasons for the observed di

ISSN:0733-2459    

DOI:10.1002/jca.2920100102

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractIt is generally assumed that using high whole blood flow rates (WBFR), 80 ml/min, during peripheral blood stem cell (PBSC) collection on the Fenwal CS 3000 Plus blood cell processor will result in higher yields of mononuclear cells (MNC) than using lower WBFR (50 ml/min). To test this assumption, we retrospectively studied 129 PBSC procedures on 17 patients in a multiple myeloma protocol comparing MNC yield, as well as red blood cell (RBC), granulocyte, and platelet (Plt) content, of four average WBFR groups. Standard PBSC procedures were performed using modified procedure 1, interface offset 100, anticoagulant (AC) ratio of 11:1, small volume collection chamber, and a processing time of 4 hours. After correcting for AC volume used, the volume processed was divided by 240 minutes to obtain the average WBFR. WBFRs were separated into 4 groups of 40–49, 50–59, 60–69, and 70–79 ml/min.When compared to the highest flow rate group (70–79 ml/min), the three lower flow rate groups had significantly higher MNC yields of 16.2 ± 6.9, 13.1 ± 5.1, and 11.5 ± 4.7 × 109, respectively, as compared to 8.9 ± 6.1 ± 109MNC for the 70–79 ml/min group. There was no significant difference in granulocyte yield which ranged from 1.6 ± 2.1 to 4.5 ± 4.8 × 109.There were also significantly more RBC in the 70–79 ml/min group with 21.1 ± 2.2 ml than all three other groups with 16.2 ± 4.3, 16.6 ± 4.0, and 17.9 ± 4.2 ml, respectively, but high average WBFR collected significantly less platelets (0.6 ± 0.7 × 1011versus 1.9 ± 1.0, 1.5 ± 0.9, and 1.2 ± 0.9, respectively). Incidence of citrate reactions increased as flow rates increased, 6%, 18%, 30%, and 33%, respectively. We conclude that using a lower average WBFR during PBSC collection actually produced significantly more MNC, with equivalent granulocytes, less RBC, but more plate

ISSN:0733-2459    

DOI:10.1002/jca.2920100103

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractIn order to establish a peripheral blood stem cell graft, repeated aphereses are necessary in the majority of patients. Each apheresis requires withdrawal and reinfusion of blood with high flow rates. To guarantee these flow rates, large‐bore catheters are needed for central venous access. Subcutaneously tunneled silicone catheters (Hickman) caused venous thrombosis in 10–40% of the patients. We therefore used polyurethane large‐bore catheters only for the time of peripheral blood stem cells (PBSC) collection. Via a Seldinger guidewire following delineation of the right (160 patients) or left (23 patients) internal jugular vein by ultrasound, 183 apheresis catheters have been inserted when the white blood cell count was>1.0 × 109/L and a measurable population of CD34+cells was detected by fluorescence‐activated cell sorter analysis. The median flow rate was 70 ml/min (range 50–80 ml/min). We observed the following complications: puncture of the carotid artery in 2%, pneumothorax in 0.5%, local infection in 3%, and catheter‐related septicemia in only 2% of the patients. At the time of the removal of the catheters, we detected thrombosis of the internal jugular vein in 5% of the patients by ultrasound. The collection of PBSC with short‐term, large‐bore catheters is effective and is associated with a low incidence of infectio

ISSN:0733-2459    

DOI:10.1002/jca.2920100104

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractFor safe autografts with peripheral blood hematopoietic cells (PBSCT), better methods for determining the kinetics of stem cell populations and predicting engraftment speed after PBSCT need to be established. Current methods include culture in semi‐solid medium and measurement of CD34 cell surface antigen. In this study with only partially purified blood cells obtained from children with cancer in remission, we compared the effects of phytohemagglutinin‐stimulated lymphocyte‐conditioned medium (PHA‐LCM) and recombinant human cytokines on the growth of progenitor cells in a methylcellulose culture system. Interleukin‐3 (IL‐3) alone supported more progenitor growth than standard PHA‐LCM by a factor of 1.54 for colony‐forming unit granulocyte/macrophages (CFU‐GM) and by a factor of 1.84 for burst‐forming unit/erythroids (BFU‐E). No significant change, in terms of the number of growing colonies, was observed by adding granulocyte/macrophage colony‐stimulating factor (GM‐CSF), granulocyte‐CSF (G‐CSF), or IL‐1 to IL‐3. However, the addition of G‐CSF resulted in increased colony size. A further increase in CFU‐GM growth was observed by the addition of IFN‐γ to the combination of cytokines. No significant effect was observed when stem cell factor (SCF) was added to the combination of cytokines containing IL‐3, G‐CSF, and IFN‐γ. This analysis suggests that the combination of IL‐3, G‐CSF, and IFN‐γ may provide sufficient stimulation for the growth of human blood cells. The effects of different oxygen tensions on progenitor growth in the presence of IL‐3, G‐CSF, and IFN‐γ were also evaluated. Both CFU‐GM and BFU‐E formation were increased when the culture was grown at 5% O2, as compared with an ambient 20% O2tension. A small number of infused cells were grown in culture incorporating either IL‐3, G‐CSF, and IFN‐γ at 5% O2or PHA‐LCM at 20% O2, and the number of infused cells was correlated to the speed of hematopoietic recovery after PBSCT. Although a significant negative correlation was observed between the number of infused CFU‐GM per kilogram of the patient's body weight and the recovery of hematopoiesis under both culture conditions, a better correlation was found when the former method was applied (Plt; .001 vs.Plt; .05). These findings suggest that a culture containing IL‐3. G‐CSF, and IFN‐γ at low O2tension provides satisfactory conditions for the proliferation of blood progenitors, and that this mixture of recom

ISSN:0733-2459    

DOI:10.1002/jca.2920100105

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe conversion of multiple whole blood donors to apheresis donors is a challenge since a rapidly expanding apheresis donor base could erode homologous collections. We addressed this concern with a plan to enhance apheresis recruitment as well as donations among homologous donors with types O and B blood. Focusing the donor's attention on blood type as it relates to type‐specific product needs was the basis of our approach. A matrix was used to recruit the desired types for the desired procedures (whole blood, platelet/plasma apheresis). The matrix instructed donors of blood types O, A‐, and B‐ to primarily give whole blood and to give apheresis as a secondary donation. Donors AB, A+, and B+ were primarily directed to apheresis donations, whole blood donation being secondary. A+ and O‐ donors only gave their secondary donation if they were at maximum donations with the primary donation.The collections by blood type in percentages for 12 months of 1992/93 for whole blood were O+ 38.9, 0‐ 7.3, A+ 29.5, A‐ 5.7, B+ 11.9, B‐ 2.1, AB+ 3.7, AB+ 0.7. For apheresis it was 0+ 36.2, 0‐ 6.7, A+ 33.0, A‐ 6.6, B+ 10.4, B‐ 1.2, AB+ 4.9, AB+ 1.0. In 1992/93, A+ and B+ apheresis collections as compared to total apheresis collections increased by 4.9% and 13.7%, respectively. For O group apheresis donations, a decrease of 2.5% was shown and A+ whole blood donations decreased by 5.35%. During the same period of time, total apheresis collections increased by 3,058 units. We demonstrated that integration of apheresis recruitment with type‐specific whole blood recruitment yielded significant increases of t

ISSN:0733-2459    

DOI:10.1002/jca.2920100106

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100107

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100108

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100109

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100110

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100111

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY