Effect observation of different collection procedures of blood cell separator on collection of autologous peripheral blood hematopoietic stem cells in children / 白血病·淋巴瘤

Objective:To investigate the effect of different collection procedures of COBE Spectra blood cell separator on collection of autologous peripheral blood hematopoietic stem cells in children.Methods:The clinical data of 10 children who were collected autologous peripheral blood hematopoietic stem cells with the monocytes (MNC) or fully automatic peripheral blood stem cells (AutoPBSC) programs of COBE Spectra blood cell separator in the Children's Hospital of Soochow University from July 2018 to January 2020 were retrospectively analyzed, and the children were 3-10 years old with the body weight of 15-31kg. There were 5 cases in MNC group and 5 cases in AutoPBSC group.Results:Autologous peripheral blood hematopoietic stem cells were collected for 25 times, with an average of 2.5 times (1-4 times), 10 times in MNC group and 15 times in AutoPBSC group. The number of stem cells [the median (the range)] before collection was 19.3/μl (3.5-129.0/μl) in MNC group and 9.4/μl (2.2-38.7/μl) in AutoPBSC group. The number of CD34 + cells of single collection was 1.22×10 6/kg (0.18×10 6/kg-6.30×10 6/kg) in MCN group and 0.85×10 6/kg (0.13×10 6/kg-2.64×10 6/kg) in AutoPBSC group. Correlation analysis showed that there was a positive correlation between the number of collected CD34 + cells and the number of stem cells before collection (AutoPBSC group: r=0.921, P < 0.01; MNC group: r=0.833, P=0.003). The collection efficiency was 5.4% (3.4%-11.2%) in MNC group and 10.4% (4.7%-13.9%) in AutoPBSC group, and the difference was statistically significant ( Z=2.163, P = 0.031). Conclusion:The collection effect of children's autologous peripheral blood hematopoietic stem cells with COBE Spectra blood cell separator AutoPBSC program is better than that with MNC program.

Therapeutic white blood cell and platelet depletions using the spectra OPTIA system continuous mononuclear cell protocol.

The Spectra Optia apheresis system has only recently been approved by the Food and Drug Administration (FDA) for therapeutic white blood cell (WBC) depletions and is not yet approved for platelet depletions. Prior to FDA-approval of the WBC depletion protocol, when our available COBE Spectra apheresis systems were out of service, we successfully performed WBC depletion using a modified Spectra Optia apheresis system Continuous Mononuclear Cell (CMNC) protocol. Using this modified Spectra Optia CMNC protocol, we created institutional protocols for WBC and platelet depletions. We performed 10 WBC depletions in 9 patients and 2 platelet depletions in 2 patients. We compared pre- and post-procedure WBC, platelet count, and hemoglobin to the same data from patients previously treated on the COBE Spectra and found no difference in % WBC and platelet reduction. We also found no significant difference in post-procedural hematocrit decline. Additionally, adverse reactions were not increased. Therefore, we conclude that the Spectra Optia CMNC protocol can be successfully modified for effective WBC and platelet depletions without increase in adverse reactions.

Comparative efficacy in red blood cell exchange transfusions with different apheresis machines in patients with sickle cell disease.

The purpose of this study is to compare the efficacy and side effects of two red blood cell exchange (RBCX) transfusion systems in sickle cell disease (SCD). The data is collected retrospectively from the January 2010 to March 2015. 447 RBCX transfusions were performed to 165 patients. Side effects, clinical and technical efficacy were compared in between procedures with Cobe Spectra (CS) and Spectra Optia (SO) systems. Furthermore a subgroup analyses was performed for 40 patients who had RBCX transfusions with both system at least two times. Vasoocclusive crises, preoperative period and foot ulcers (49.6, 13, and 15.2% respectively) were the common indications of RBCX transfusion. While the levels of post-RBCX HbS and the actual fraction of cells remaining (FCRa) were found significantly higher in the SO compared to CS system (p = 0.018 and p = 0.016 respectively), the rate of targeted hemoglobin S (HbS) levels (< 30%) were same in both. The length of procedure and replacement volume were significantly lower in SO compared to CS system (p = 0.025 and 0.044 respectively). Subgroup analyses of 40 patients did not reveal any statistically significant differences regarding post-procedure HbS levels, FCRa levels, replacement volume and procedure duration. The inter-rater correlation coefficient for FCRa was calculated to be 0.82. Serious adverse reactions were not observed from either system. Both systems are efficiently achieved the targeted post-procedure HbS level. The recently introduced SO apheresis system is as effective and safe as the CS system, which has been used for all indications of SCD for years.

First comparative analysis concerning the plasma platelet contamination during MNC collection.

BACKGROUND AND OBJECTIVES: Monocytes can be cultured into dendritic cells with addition of autologous plasma, which is highly prone to platelet contamination due to the apheresis process. Since platelets affect the maturation process of monocytes into dendritic cells and might even lead to a diminished harvest of dendritic cells, it is very important to reduce the platelet contamination. A new collection device (Spectra Optia) was analyzed, compared to two established devices (COM.TEC, Cobe Spectra) and evaluated regarding the potential generation of source plasma. MATERIALS AND METHODS: Concurrent plasma collected during leukapheresis was analyzed for residual cell contamination in a prospective study with the new Spectra Optia apheresis device (n=24) and was compared with COM.TEC and Cobe Spectra data (retrospective analysis, n=72). Donor pre-donation counts of platelets were analyzed for their predictive value of contaminating PLTs in plasma harvests. RESULTS: The newest apheresis device showed the lowest residual platelet count of the collected concurrent plasma (median 3.50×109/l) independent of pre-donation counts. The other two devices and sets had a higher platelet contamination. The contamination of the plasma with leukocytes was very low (only 2.0% were higher than 0.5×109/l). CONCLUSIONS: This study showed a significant reduction of platelet contamination of the concurrent plasma collected with the new Spectra Optia device. This plasma product with low residual platelets and leukocytes might also be used as plasma for fractionation.

Comparison of Amicus and COBE Spectra for allogenic peripheral blood stem cell harvest: Study from tertiary care centre in India.

INTRODUCTION: Most common source of stem cell graft for both autologous and allogenic haematopoietic transplants are peripheral blood haematopoietic progenitor stem cells. Adequate collection of the CD34+ cells and safety of the allogenic donor during the leukapheresis are of prime importance to an apheresis physician. Our retrospective analysis is a comparison between of two platforms namely, COBE Spectra and Amicus, for CD34+ mononuclear cell collection. MATERIAL AND METHOD: The study included the data of GSCF (Granulocyte-Colony-Stimulating Factor) mobilized allogenic PBSC collections at our centre from January 2015 to June 2016. The apheresis platforms used were COBE Spectra and Amicus. Blood cell counts were done using LH750 Beckman Coulter (Florida, Miami, USA). CD45+ & CD34+ cell counts were done using BD FACS Canto-II Flow-Cytometer by ISHAGE guidelines. RESULTS: A total of 170 PBSC (100 COBE Spectra & 70 Amicus) harvests were done on 143 donors, of which 116 completed the collection in a single session and 27 required a second session. Demographic details and pre harvest peripheral blood counts for both the groups did not show any statistical differences. Amicus processed higher blood volume with higher ACD exposure and procedure time compared to COBE Spectra. Higher platelets loss was with COBE Spectra harvests with higher product volumes collection. Collection efficiency (CE2), collection ratio, CD34+ cells dose was similar on both the platforms. RBC contamination, absolute lymphocyte and monocytes counts were significantly higher with Amicus harvest product compared with COBE Spectra. A total of 14 (8.2%; citrate toxicity) adverse reactions were reported out of 170 allogenic PBSC collections. DISCUSSION/CONCLUSION: Our study suggests that both Amicus and COBE Spectra platforms offer comparable results for allogenic PBSC collections. Amicus offers a concentrated PBSC product with lesser volume and platelets loss but higher RBC contamination.

Comparison of Spectra Optia and COBE Spectra apheresis systems' performances for red blood cell exchange procedures.

BACKGROUND: Spectra Optia (Terumo BCT, Lakewood, CO) was FDA approved for red blood cell exchange (RBCx) procedures in January 2014 and is expected to replace COBE spectra (Terumo BCT) very soon in the USA. The performance characteristics of these devices for Isovolemic Hemodilution (IHD-RBCx) procedure were compared in this study. METHODS: A total of 114 IHD-RBCx procedures from 19 patients were analyzed. For every patient, three procedures on each device with similar pre-procedure hematocrits were compared. Pre and post procedure laboratory parameters compared were hemoglobin S (HbS), hematocrits (Hct), platelet counts and fraction of cells remaining (FCR). Statistical analysis was performed using t-test adjusted by the Holm-Bonferroni method to reduce family-wise error rate. RESULTS: There were no significant differences between these two devices in regards to HbS, Hct, FCR and platelet counts (p = > 0.05). However, rinseback volume (124.2 ± 8.9 ml) and normal saline replacement volume during IHD phase (296.1 ± 97.2 ml) were lower in Spectra Optia as compared to COBE Spectra (337 ± 33.8 ml and 326.6 ± 105.2 ml, p value <0.001 and 0.030 respectively). Spectra Optia had a longer run time (107.1 ± 15.9 min vs 123.8 ± 19.6 min, p value <0.001) overall. CONCLUSIONS: Performance characteristics of Spectra Optia for HbS, Hct and FCR were similar to COBE Spectra for IHD-RBCx. IHD-RBCx procedure on Optia required less normal saline replacement volume and rinse back volume but with overall longer procedure run time.

Comparative evaluation of the depletion-red cell exchange program with the Spectra Optia and the isovolemic hemodilution-red cell exchange method with the COBE Spectra in sickle cell disease patients.

BACKGROUND: This study aims to compare in patients with sickle cell disease (SCD), the technical performance and packed red blood cell unit consumption between the automated depletion/Red Blood Cell exchange (RBCx) program (Spectra Optia Apheresis System) with the isovolemic hemodilution (IHD)/RBCx procedure (COBE Spectra Apheresis System) in a routine clinical setting. METHODS: We retrospectively reviewed the data of 23 patients treated between October 2010 and August 2013 who underwent repeated RBCx on both apheresis systems for preventive indications. Each patient was their own control and had undergone two procedures on each system, totaling 46 sessions per group. On Spectra Optia, we performed the automated depletion/RBCx program. For COBE Spectra, we used a modified IHD/RBCx protocol. All patients had an initial 250 mL depletion offset by a 5% albumin prior to the exchange procedure, for the respective device, with leucodepleted Rh/Kell compatible and cross-matched RBC packs. RESULTS: All procedures were well tolerated except three mild febrile nonhemolytic reactions. Postprocedure hemoglobin S (HbS), fraction of cells remaining (FCR), procedure duration and processed blood and anticoagulant volumes were comparable in the two groups. However, the RBCx volume was significantly higher for the Spectra Optia group (+71 mL, P = 0.01), with no significant difference in the number of RBC units used. CONCLUSIONS: Technical performance and packed RBC unit consumption were not compromised when switching from the COBE Spectra IHD/RBCx protocol to the depletion/RBCx protocol on the Spectra Optia. Tolerability was equal for both protocols. J. Clin. Apheresis 31:429-433, 2016. © 2015 Wiley Periodicals, Inc.

Changes of Electrolytes, Hemoglobin and Platelets before and after Peripheral Blood Stem Cell Collection / 대한임상병리학회지

BACKGROUND: Many studies have reported hypocalcemia during peripheral blood stem cell (PBSC) collection. On the other hand, changes in other electrolyte levels such as potassium have received little attention. To see if it is necessary to monitor other electrolytes, we determined sodium, potassium, chloride, total CO(2), and ionized calcium before and after the PBSC harvest. The changes in hemoglobin and platelets were also investigated. METHODS: A total of 111 PBSC harvest procedures for thirty-six patients or donors were included in this study. The samples were collected within 2 hours around PBSC harvest. Patients who received blood transfusions or in whom electrolytes were administered immediately before or during the procedure were excluded from the evaluation. RESULTS: In the autologous PBSC harvest using CS3000, all five electrolytes showed significant changes. Ionized calcium significantly dropped by about 7.2+/-13.1% at the end of apheresis. Potassium significantly decreased to 12.3+/-10.2% during PBSC harvest. Hemoglobin and platelets significantly decreased except the autologous PBSC harvest using CS3000 and Cobe, respectively. CONCLUSIONS: Our data reveal a strong association between anticoagulant-induced hypocalcemia and concomitant hypokalemia during the PBSC harvest. We suggest that the potassium level should be carefully monitored, especially for patients with relatively low preharvest potassium levels.

Comparison of Leukocyte Depletion between COBE Spectra LRS/TM and COBE Specta followed by PALL PXL/TM 8 on Single Donor Platelet

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell(WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRS (leukoreduction system) and COBE Spectra with PALL PXL 8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit(APU) in St. Mary s hospital were prospectively randomized into COBE Spectra LRS and COBE Spectra followed by PALL PXL 8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6+ 1.0 x 10 ' with COBE spectra LRS compared to 2.9+ 1.1 X 10 with COBE Spectra(p=0.002), and the mean WBC content per unit with COBE spectra LRS was 4.1 x 104(0.4-23.5) compared to 3.7 x 104(0.43-17.9) with PALL PXL""8(p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRS has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXL 8. Therefore, this data suggests that COBE Spectra LRS is conveient than COBE Spectra with PALL PXL 8 in clinical practice. (Korean J Blood Transfusion 10(1): 43-51, 1999)

Comparison of Leukocyte Depletion between COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 on Single Donor Platelet / 대한수혈학회지

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell (WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRSTM (leukoreduction system) and COBE Spectra with PALL PXLTM8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit (APU) in St. Mary's hospital were prospectively randomized into COBE Spectra LRSTM and COBE Spectra followed by PALL PXLTM8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6 +/- 1.0X1011 with COBE spectra LRSTM compared to 2.9 +/- 1.1X1011 with COBE Spectra (p=0.002), and the mean WBC content per unit with COBE spectra LRSTM was 4.1X104 (0.4-23.5) compared to 3.7X104 (0.43-17.9) with PALL PXLTM8 (p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRSTM has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXLTM8. Therefore, this data suggests that COBE Spectra LRSTM is conveient than COBE Spectra with PALL PXLTM8 in clinical practice.

Large-Volume Leukapheresis for Collection of Peripheral Blood Stem Cells: A Comparison of Two Continous Flow Cell Separators / 대한혈액학회지

BACKGROUND: Mobilized peripheral blood stem cells (PBSCs) are now used increasingly in patients with hematologic and solid tumors to reconstitute hematopoiesis after dose-intensive chemotherapy. We evaluated the efficacy of large-volume leukapheresis (LVL) and compared the ability of Fenwal CS3000 Plus and Cobe Spectra to collect mononuclear cells (MNCs) for PBSCT. METHODS: Twenty liters of whole blood per LVL were processed in 22 patients with acute leukemia and lymphoma. LVL were performed in rapid recovery phase (white cells >3x109/L, or CD34+ cells > 1% of white cells) after chemotherapy followed by granulocyte-colony stimulating factor. The end point of LVL was mononuclear cells (MNCs) >8x108/kg, or CD34+ cells > 6x106/kg. A-35 collection chamber was used in Fenwal CS3000 Plus and whole blood flow was set at 85mL/min, whole blood to anticoagulant ratio 11~13:1, interface offset 150. MNC procedure was used in Cobe Spectra, whole blood flow was 90~100mL/min, whole blood to anticoagulant ratio 24:1 with heparin to anticoagulant and product bags, collection rate 1mL/min, and hematocrit 2~3%. RESULTS: Total 53 LVL (35 with Fenwal CS3000 Plus and 18 with Cobe Spectra) were performed on 22 patients. An average of 2.4 LVL per patient (range 1~4) were performed. With Fenwal CS3000 Plus, post-LVL values of hematocrit, platelets and MNCs were reduced by 12.4%, 53.1%, and 33.0% and with Cobe Spectra, 9.2%, 36.1%, and 39.6%, respectively. Mean collection volume of Fenwal CS3000 Plus and Cobe Spectra were 135.7mL and 175.2mL per LVL, respectively. There was no statistical significant difference in the yields of LVL between Fenwal CS3000 Plus (3.4+/-1.9x108/kg MNCs, 7.2+/-11.2x106/kg CD34+ cells) and Spectra (4.7+/-2.1x108/kg MNCs, 7.4+/-9.6x106/kg CD34+ cells). The yields of LVL were correlated well with patients' pre-MNC counts in both cell separators. Mean percentages of MNC were 95.4% with Fenwal CS3000 Plus and 74.0% with Cobe Spectra (P 0.05). LVL product with Cobe Spectra contained less red cells (10.5+/-2.7mL) than Fenwal CS3000 Plus (34.1+/-10.8mL) (P<0.001). Platelet contamination was not different for Fenwal CS3000 Plus (2.3+/-2.1x1011) and Cobe Spectra (3.1+/-1.0x1011). CONCLUSION: LVL could be conveniently used for PBSC collection with good collection efficiency and safety without serious citrate toxicities. LVL products with Fenwal CS3000 Plus showed less collection volume and granulocyte contamination. The products with Cobe Spectra showed less red cell contamination and less decrease in patients' platelet counts.

Evaluation of COBE Spectra "Leukocyte Reduction System (LRSTM)" for the Production of Leukocyte-Reduced Platelets / 대한수혈학회지

BACKGROUND: Leukocytes have been shown to be an undesirable contaminants in platelet transfusions because these contaminants may develop various adverse consequences. Current platelet products by plateletpheresis are heavily contaminated with leukocytes. Recently, new platelet apheresis system (COBE Spectra LRSTM) was designed to make it possible to collect platelets with very low leukocytes contamination. We evaluated the COBE Spectra LRSTM by comparing it with COBE Spectra. METHODS: Plateletpheresis procedures were performed on 75 normal donors; 45 procedures for COBE Spectra LRSTM and 30 procedures for COBE Spectra. We evaluated platelet yields, processing times, efficiency, and leukocytes content on two apheresis machines. RESULTS: Comparative results of COBE Spectra LRSTM with COBE Spectra were as follows: the mean processing time per unit was 97 min and 91 min, the efficiency per unit was 38.4 +/- 11.5% and 46.9 +/- 12.1%, the mean leukocytes contamination per unit was 6.1x104 and 2.1x106 respectively (p0.05). CONCLUSIONS: Platelet collections with COBE Spectra LRSTM demonstrated comparable platelet yields and strikingly low WBC contamination. This study indicate that the COBE Spectra LRSTM is an efficient and reliable system for the collection of platelets with very low residual WBC levels. It seems that leukocyte reduction filter for platelet products by COBE Spectra LRSTM is not necessary for further removal of leukocytes to prevent alloimmunization, non-hemolytic transfusion reactions, certain viral and bacterial infections.