Large‐volume leukapheresis for peripheral blood stem cell collection in patients with hematologic malignancies

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Abstract
Large‐volume leukapheresis (LVL, 15–35 L) was performed in two groups of patients (n = 10) with hematologic malignancies to obtain peripheral blood stem cells for bone marrow rescue following high‐dose chemotherapy. The target cell count was 7 × 10(8) mononuclear cells (MNCs = lymphocytes and monocytes) per kg of body weight. Group A patients (n = 4) were studied on Day 1 of LVL, and components were collected from them as four sequential samples. Total MNCs collected averaged 1.29 × 10(10), total colony‐forming‐units granulocyte‐ macrophage (CFU‐GM) averaged 12.1 × 10(6), and a 1.8‐fold mobilization of CFU‐GM was observed (p < 0.05, Sample 1 vs. Sample 4). Group B patients (n = 6) were studied throughout the three consecutive planned days of 5‐hour LVL. An average of three LVL procedures per patient was performed (range, 1.25‐4), and an average of 27 L (range, 24–33) of blood per LVL was processed. The blood:ACD‐A ratio was 24:1 with 3000 units of heparin per 500 mL of ACD‐A; heparin was also added to the collection bags. The component had an average hematocrit (Hct) of 0.02 and MNC content of 93 percent. The patients' pre‐LVL and post‐LVL average Hct varied significantly (before Day 1, 0.36 +/− 0.08; after Day 3, 0.28 +/− 0.06; p < 0.05). Platelet counts also decreased, with post‐Day 3 counts averaging 19 percent of the average pre‐Day 1 counts (p < 0.05). A decrease in the average MNC count after LVL was significant on Day 1 only (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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