QUINTON-MAHURKAR CATHETER AS SHORT-TERM CENTRAL VENOUS ACCESS FOR PBSC COLLECTION - SINGLE-CENTER EXPERIENCE OF 370 APHERESES IN 110 PATIENTS

We retrospectively analyzed our experience with the Quinton-Mahurkar d ual-lumen hemodialysis catheter as short-term central venous access fo r harvesting peripheral blood stem cells (PBSC) for autologous transpl antation, For intensification therapy for various malignancies 370 leu kaphereses were performed in 110 candidates. The catheter was placed p ercutaneously under local anesthesia only for the time of blood collec tion and in no case was it used for the PBSC transplant, No systemic a ntithrombotic prophylaxis was administered, PBSC were collected using a continuous flow cell separator, COBE Spectra, after mobilization wit h chemotherapy followed by cytokine: rhGM-CSF and rhG-CSF s.c. (35 pat ients) or rhG-CSF s.c. alone (75 patients). The median number of apher eses was two (1-13), Eighty-nine patients (81.3%) required three or fe wer sessions to collect the minimum mononuclear cell target number of 6 x 10(8) MNC/kg. The volume of blood per kg body weight processed for each apheresis was 240 ml (range 150-560 ml) equivalent to 13 l (6-30 l) and the median flow rate was 61 ml/min (range 30-90 ml/min), The t otal CD34(+) cell yield per patient was 3.55 x 10(6)/kg (0.26-34.8) an d the MNC yield was 6.1 x 10(8)/kg (2.96-12.6), We observed the follow ing complications: local infection in four cases (3.6%), catheter occl usion for local thrombosis in two cases (1.8%) and pneumothorax in one case (0.97%), In our experience the Mahurkar-Quinton catheter, when p laced specifically for apheresis sessions, was very effective and safe for PBSC harvesting with a low incidence of complications.