Selecting the optimal dose of low‐molecular‐weight hydroxyethyl starch (Pentastarch) for granulocyte collection

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Abstract
A new, rapidly excreted, low‐molecular‐weight form of hydroxyethyl starch (Pentastarch), is effective and safe in centrifugation leukapheresis. To define the optimal dose of Pentastarch, 12 subjects donated granulocytes by continuous‐flow, centrifugation leukapheresis on three occasions at 3‐week intervals. Each subject received approximately 250,500, or 1000 ml of Pentastarch according to a random sequence during procedures in which 81 of donor blood was consistently processed. Plasma Pentastarch concentrations (mean mg/ml) measured immediately after leukapheresis were 3.1, 6.7, and 12.7 for the 250, 500‐, and 1000‐ml doses, respectively. Total leukocyte and neutrophil yields with the 500‐ or the 1000‐ml doses of Pentastarch were similar, and both were significantly greater (p < 0.05) than those with the 250‐ml dose. Neutrophil yields per concentrate (mean × 10(‐10) were 0.74, 1.72, and 1.73 for the 250‐, 500‐, and 1000‐ml doses, respectively. Pentastarch dose had little effect on lymphocyte and platelet yields. No serious adverse effects were evident for any dose of Pentastarch during 12 weeks of observation. In particular, the 1000‐ ml dose did not produce increased toxicity. Thus, a single 500‐ml bottle of 10 percent Pentastarch produced maximal yields; efficacy was not improved by doubling the dose.