THERAPEUTIC CYTAPHERESIS - CONTINUOUS-FLOW VERSUS INTERMITTENT FLOW APHERESIS SYSTEMS

In this retrospective study, we compared two systems, continuous flow (CF) (COBE Spectra) versus intermittent flow (IF) (Haemonetics V-50, M -30), in performance of therapeutic plateletapheresis (TP: N = 49 each ) and therapeutic leukapheresis (TL:N = 29 each). Pre- and post-proced ure cell reductions, specificity of removal, volumes removed, and inci dence of adverse reactions were compared. Standard procedures with min or modifications, starch with IF only, and 180 minutes blood processin g time were used. The CF system had a significantly lower percent redu ction of platelets during TP at 43 +/- 17% than IF at 53 +/- 19%. Howe ver, no significant difference was found between CF and IF in percent reduction of white blood cells during TL with 49 +/- 16% and 42 +/- 14 %, respectively. The CF system had significantly less hemoglobin reduc tion (5 +/- 4% vs. 19 +/- 9%, respectively) and white blood cell reduc tion (13 +/- 15% vs. 27 +/- 17%, respectively) for TP than IF and lowe r (not significant) hemoglobin reduction (9 +/- 8% vs. 12.4 +/- 8.2%, respectively) as well as platelet reduction (27 +/- 18% vs. 35 +/- 19% , respectively) for TL. CF also had significantly less volume removed than IF during TP (559 +/- 97 vs. 883 +/- 304, respectively) and TL (7 10 +/- 134 vs. 1405 +/- 421 ml, respectively). Incidence of reactions was lower for CF than IF during TP (8% vs. 10%, respectively) and duri ng TL (14% vs. 21%, respectively). Using our techniques, we found both the CF and IF flow systems were capable of adequately reducing cell c ounts for TP and TL; however, IF was significantly better in reducing platelet counts during TP. The CF system was more specific in its cell reductions as indicated by lower hemoglobin reductions, WBC reduction s (TP), platelet reductions (TL), and volume removed. Reaction inciden ce was also lower for the CF system. (C) 1994 Wiley-Liss, Inc.