System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Case Reports Clinical Trial Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Ppublish 3 citations

PubMed: 34160085 DOI: 10.1111/trf.16551

Process and procedural adjustments to improve CD34+ collection efficiency of hematopoietic progenitor cell collections in sickle cell disease.

Transfusion 61(9):2775-2781

Authors: Scott T Avecilla, Farid Boulad, Karina Yazdanbakhsh, Michel Sadelain, Patricia A Shi

Affiliations

  • Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, USA.
  • Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Lindsley F. Kimball Research Institute (NYBC), Sickle Cell Program, Division of Hematology, Albert Einstein College of Medicine, Bronx, New York, USA.

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 AND METHODS

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.

MeSH

Cells, Blood Transfusion, Hematology, Blood, Anemia, Sickle Cell, Stem Cells, Granulocytes, Blood Platelets, Hematopoietic Stem Cells

Cited by