Collection efficiency of hematopoietic cells by apheresis after mobilization in a single centre: Analysis of the last 15 years.

Abstract

Background and objectives: Peripheral blood hematopoietic cells (CD34+) collection after mobilization by apheresis has largely replaced bone marrow harvest because of its safety and superior transplantation outcomes. This study aimed to evaluate temporal trends and factors influencing CD34+ collection efficiency (CE) by measuring counts before and after apheresis (CE1, in general considered a more accurate estimate of CE) over a 15-year period.

Materials and methods: CD34+ cell mobilization was achieved using individualized drug regimens tailored to donor characteristics and underlying diagnosis. Apheresis procedures were carried out using Cobe Spectra, Spectra Optia and Amicus devices. Descriptive and analytical statistical analyses were performed using SPSS v29.0.

Results: A total of 1435 collections from 1233 donors (658 males, 575 females; age 15-76 years) were analysed. Mean CD34+ CE1 increased significantly over time (p < 0.001). There was no statistically significant differences in CE1 between the six group of donors considered, but there were differences in CD34 counts before apheresis, number of total blood volume processed to reach the target number of CD34+ and the duration of collection. Male donors and individuals aged up to 39 years achieved the highest CE1. Pre-apheresis CD34+ count, leukocyte count, low mean corpuscular volume (MCV) and high platelet count inversely correlated with CE1.

Conclusion: CD34+ CE1 improved significantly over the past 15 years, probably due to technological advancements. Several factors negatively influenced CE1, although some of them can be compensated for by changing the collection parameters in the apheresis platforms. The findings support optimization of apheresis protocols to reach maximum CD34+ CE1.