A Single Center 25-year Experience in Autologous Peripheral Blood Stem Cell Collection: A Focus on the Collection Efficiency

Background: Harvest of hematopoietic progenitor cells via leukapheresis is being used increasingly for autologous transplantation. Adequate yield of cells per kilogram body weight of recipient is required for a successful engraftment. Collection efficiency (CE) is a useful parameter to assess quality of peripheral blood stem cell (PBSC) collection program. In this study, we report a 25-year experience in a tertiary care Hospital in Italy.

Patients and Methods: 1,026 consecutives autologous PBSC collection procedure, performed in 763 patients, from January 1996 to December 2020 were retrospectively considered. Data regarding patients, Blood Cells Separators (BCS) , apheresis procedures and PBSC products were collected in our database. In these 25 years different BCS were adopted in our Apheresis Unit (AU). In the first period (1996-1999) we used Fresenius Com. Tec, in the central period (2000-2013) we used Cobe Spectra and in the last period (2014-2020) Spectra Optia.

Results: As regards the evaluation of patients before leukapheresis, the most significant data was the increasing number of CD34+ cells. Considering the PBSC collection procedure, there was a progressive increase in the processed blood volume with a shorter apheresis duration. Data related to the PBSC collection demonstrated an increasing CD34+ cell yield and efficiency a raise in CE that was 43% using Fresenius COM-TEC BCS, 49% using Cobe Spectra BCS and 53% using Spectra Optia BCS. .

Conclusions: These results were observed considering a 25-year period, thus a great number of factors likely contributing to the observed results, including technological improvement of the instrumentation for leukapheresis, increased experience of the team operating in the Apheresis Unit, improved mobilization protocols, better criteria for patients’ selection. Focusing our attention on CE we observed quite satisfactory results with a median which rose from 43% to 53% with an increase of 10% in the observation period.