RESUMEN
BACKGROUND: Collection efficiency (CE) of peripheral blood stem cell (PBSC) collections is negatively affected by increasing white blood cell (WBC) counts of the patient. This study compared a new optimized mononuclear cell (MNC) collection protocol (OPP) to the standard MNC collection protocol recommended by the manufacturer (STP) for PBSC collection in patients with WBC counts >35 000/µL. STUDY DESIGN AND METHODS: Single-center, retrospective, and observational study of 81 autologous PBSC collections on Fenwal Amicus cell separators in 70 adult patients. RESULTS: Median peripheral WBC count (×103 /µL; 44.2 in OPP group vs 46.5 in STP group) and median CD34+ count (105/µL in OPP group vs 40/µL in STP group) at the beginning of PBSC collection did not differ significantly. Median CE2 (45% vs 31%; P < .001) as well as CD34+ yield of the apheresis product both with regards to median absolute CD34+ content (×106 ; 793 vs 188; P = .001) as well as median CD34+ content (×106 )/kg body weight (8.93 vs 2.51; P = .002) were significantly higher for the OPP. Overall, 18/21 (86%) patients with the OPP obtained their target CD34+ amount with a single apheresis session, compared to 25/50 (50%) with the STP (P = .005). PBSC collections using OPP lasted significantly longer (median 377 minutes vs 260 minutes; P < .001) than with the STP. CONCLUSIONS: The OPP significantly improves CE2 for PBSC collections on Fenwal Amicus cell separators in patients with pre-apheresis WBC counts >35 000/µL and significantly reduces the necessity for multiple apheresis sessions. The OPP is therefore suited to reduce both patient burden and cost in autologous PBSC collection.