Evaluation of a new continuous mononuclear cell collection procedure in a single transplant center cohort enriched for AL amyloidosis patients.

BACKGROUND: The Spectra Optia continuous mononuclear cell (CMNC) program is newly available, and herein validated in a single-center cohort enriched with AL amyloidosis patients to collect a target CD34+ yield of 2.5 × 106 cells/kg within 2 days. METHODS: Consecutive autologous transplant patients in 2016 are included. Patients undergo leukapheresis with Optia CMNC and Spectra v4.7 over a 2-day cycle. Data collection includes collection efficiency, adverse events and engraftment kinetics. RESULTS: 36 leukapheresis procedures on 18 patients are included. The diagnoses are AL amyloidosis (9), myeloma (7), lymphoma (2), and scleroderma (1). Median age is 60; 12 are men. Plerixafor was employed pre-emptively in 6 cycles. Median blood CD34+ on Day 1 of leukapheresis was 46 cells/uL. Median number of blood volumes processed on Day 1 was 3.1. All collection cycles were completed within 2 days; only one in a heavily pretreated lymphoma patient did not reach the target requiring a second mobilization attempt. Mean collection efficiencies were comparable between the two devices. There were 2 adverse events: tubing rupture on the Optia; and one case of hypotension. All 18 patients underwent high-dose chemotherapy: median cell dose infused was 7.7 × 106 CD34+ cells/kg. Median days to neutrophil and platelet engraftment were 10 and 13 respectively. CONCLUSION: The Optia CMNC collection protocol is safe and effective in a small single-center autologous stem cell transplant cohort enriched for high-risk patients with AL amyloidosis and cardiac involvement. Caution is needed for tubing setup because there is less cumulative experience with Optia.

Barriers and Facilitators to Adhering to the American Heart Association's Life's Simple 7 for African American Women Living in Public Housing.

African American (AA) women living in public housing have some of the highest risk factors for cardiovascular disease (CVD). Limited information exists on this population's perceived barriers and facilitators to achieving optimal heart health and adhering to practices known to lower risk factors for CVD. Six 1.5-hour long focus groups among 32 AA women living in public housing (mean age = 49.9±10.3) were conducted, audiotaped, and transcribed. Participants' quotes were analyzed using the American Heart Association Life's Simple 7 as a guideline for optimal heart health. Focus groups revealed stress and finances as primary barriers, and family/friends/social support as primary facilitators. Participants also mentioned a lack of community involvement and limited government assistance focused on making healthy foods affordable. The information gained from this study can help future programs more adequately assist this underserved group in pursuing heart healthy behaviors and lowering their disproportionately high CVD risk.