Evaluation of the spectra Optia® mononuclear cell collection procedure in multiple myeloma patients.

BACKGROUND: Peripheral blood stem cell (PBSC) rescue following myeloablative therapy is a mainstay of cancer therapy. To evaluate the ability of the Spectra Optia Apheresis System (SO), a newly developed apheresis device, the device was studied in multiple myeloma patients undergoing a first autologous PBSC transplant. AIM: To demonstrate that neutrophil recovery was not inferior to historical controls when SO harvested PBSCs were reinfused following myeloablative therapy. METHODS: Multiple myeloma patients were mobilized according to the standard practice at four clinical sites. Following mobilization, MNC collections were performed on the SO. The collected cells were cryopreserved and reinfused following myeloablative chemotherapy. Neutrophil recovery defined by an absolute neutrophil count exceeding 500/µL (ANC500) was compared to historical data for patients transplanted following apheresis using the COBE Spectra (CS) device. RESULTS: The median day to neutrophil recovery was 12 days (range 10-14 days), with no significant difference in engraftment comparing patients transplanted with stem cells collected using the SO versus historical cohort of patients collected with the CS. CD34+ cell and MNC collection efficiency (CE) were 69.3% and 65.0% for the SO and CS, respectively. Platelet CE, product hematocrit and product granulocytes (as % of WBCs) using the SO were 21%, 2.3% and 28%, respectively. There were no device-related severe adverse events. CONCLUSIONS: The study's results confirm that the Spectra Optia Apheresis System's MNC Collection Protocol is safe and effective for its intended use and that engraftment kinetics of cells collected by SO is not inferior to the CS System.

Can GEWF solution improve the retrieval of lymph nodes from colorectal cancer resections?

CONTEXT: Lymph node status is an important prognostic factor in colorectal cancer staging. OBJECTIVE: To determine whether the use of GEWF solution (glacial acetic acid, ethanol, distilled water, formaldehyde) increases the yield of lymph nodes (LNs) from colorectal cancer specimens. DESIGN: A prospective study investigated the usefulness of GEWF in identifying LN from colorectal cancer resection specimens. After standard formalin fixation, approximately half of the specimens were placed in GEWF solution, and the remainder were used as a control. The number of LNs, patient sex, length of specimen, site of the specimen, tumor staging, and the number of positive LNs were analyzed. The numbers of retrieved and metastasis-positive LNs were recorded and compared with specimens from the previous year, in which no GEWF solution was used. Residents were educated on the importance of LN status before the study. Data were analyzed using independent-sample t tests. The residents also completed a subjective survey at the conclusion of the study. RESULTS: A total of 85 specimens, 45 (53%) with GEWF and 40 (47%) without GEWF, were examined by 11 residents. The mean number of retrieved LNs using GEWF was slightly higher than the control group (19.96 vs 18.30); however, there was no statistical significance (P = .53). The mean number of LNs from the current study (2004- 2005) is significantly higher than that from the previous year (2003-2004) (19.17 vs 11.51, P < .001). CONCLUSIONS: GEWF did not increase the yield of LNs from colorectal cancer specimens. However, application of the guideline for a minimum of 12 LNs significantly increased the LN retrieval.