Process and procedural adjustments to improve CD34+ collection efficiency of hematopoietic progenitor cell collections in sickle cell disease.
Transfusion
; 61(9): 2775-2781, 2021 09.
Article
en En
| MEDLINE
| ID: mdl-34160085
ABSTRACT
BACKGROUND:
Adequate CD34+ collection efficiency (CE) is critical to achieve target CD34+ cell doses in hematopoietic progenitor cell (HPC) collections. Autologous HPC collection in sickle cell disease (SCD) is associated with unstable collection interfaces and low CD34+ CEs. We hypothesized that variables specific to SCD, activation of blood cells and elevated viscosity, might contribute to these issues and made adjustments to the collection process and procedure to address our hypothesis. STUDY DESIGN ANDMETHODS:
In two patients with SCD undergoing autologous HPC collection on our clinical trial (NCT02193191), we therefore implemented adjustments to the process and procedure in the following areas proximity of RBC exchange to HPC collection, the type of anticoagulation, and the packing factor setting.RESULTS:
There was no collection interface instability. Our CD34+ CE1s were high at 70% and 51%, and granulocyte CE, platelet CE, and product granulocyte % were remarkably low. Product hematocrits were not as high as previously reported to be required to obtain adequate CEs. Interestingly, one HPC product showed a hemoglobin S (HbS) of 91% at the same time that the peripheral blood (PB) showed a HbS of 22%.DISCUSSION:
Adjustments to the HPC collection process and procedure were associated with adequate CD34+ CEs and low granulocyte and platelet contamination in HPC products from SCD patients. Given the discrepancy in the percentage of sickle RBCs in the product versus the PB, we hypothesize that CD34+ cells and RBCs may aggregate. Our interventions and hypothesis should be further investigated in larger studies.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Células Madre Hematopoyéticas
/
Antígenos CD34
/
Movilización de Célula Madre Hematopoyética
/
Anemia de Células Falciformes
Límite:
Humans
Idioma:
En
Revista:
Transfusion
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos