Poster Session I: Transfusion medicine
For many years, the apheresis system used in many transplant centers for collection of hematopoietic progenitor cells was the COBE® spectra. Recently, this has been replaced by the Spectra OPTIA® system, which has an automatic interface adjustment system that controls the interface position of the buffy coat for the HPC collection, and handles a smaller amount of extracorporeal volume. This greater automation of the procedure facilitates the technique and makes it less operator-dependent.
To compare the efficacy and safety of two continuos cell separators for HPC collection in healthy donors, the Spectra OPTIA® (Terumo BCT) system with respect to the COBE® Spectra (Terumo BCT) previously used for years in our center.
We retrospectively analyzed 115 healthy donors who underwent apheresis of HPC for allogeneic transplantation in our center from January 2012 to December 2018. In all cases, HPC mobilization protocol was with G-CSF alone at dose of 5 μg/kg/ 12 h subcutaneous for 4 days. We performed the data analysis of two groups according to the collection device used (COBE® Spectra until May 2015 and Spectra Optia® since its implementation in our institution in June 2015). For HPC collection, the COBE® Spectra used the MNC program and the Spectra Optia® used the cMNC method. All procedures were performed at a collection rate of 1.0 ml/min. We analyze the characteristics of the apheresis procedure and the HPC product collected. We compare the WBC counts and CD34+ pre-apheresis counts in the donor, as well as the duration of leucoapheresis procedure, blood volumen processed and the values of the product, including volume, hematocrit, total WBC counts, CD34+ cells, viability and efficiency of the apheresis. Finally, the post-apheresis WBC count in the donor is analized, as well as the percentage of platelets lost.
Collection efficiencie was determined as follows: total CD34+ cell count per apheresis / (whole blood volumen processed - anticoagulant volumen) x pre-CD34+ in percentage. Stadistical analysis was performed by using Student′s t test and P <0.05 was considered significant.
Two groups were analyzed: COBE® Spectra (n = 59) and Spectra Optia® (n = 56), whose populations are homogeneous. In the first group, 36 (61%) were males and 23 females (39%) vs 24 (43%) and 32 (57%) in the second. The median age was 48 vs 46.5 years (ranges 20-72, 21-73). The median height was 172 cm in the first group (range 151-193) versus 170 cm (range 153-192) in the second. The median weight of the donors was 78 kg (45-125) in the first group vs 73 kg (45-110) in the second group; the median weight of the recipients was 65 kg (39.8-100) vs 74 kg (48-108) in the first and second group respectively. Two donors required central venous catheter in the Optia group. No relevant adverse events were observed in any group during the apheresis procedures. The results of the pre and post apheresis variables analyzed in the donor, the product, as well as the characteristics of the procedure are shown in the table.
In our experience, both apheresis systems are comparable for HPC collection, but the Optia® system improves the quality of the product collected by reducing its hematocrit and therefore its contamination with red cells, which is important in the context of ABO incompatible allogeneic transplantation. We have found a significant better efficiency in the Optia® group. We observed a similar apheresis time in both groups, slightly shorter with the Optia® system, and it is necessary to process a smaller amount of blood volume with respect to the COBE® Spectra.