Non-cryopreserved peripheral blood progenitor cells collected by a single very barge-volume leukapheresis: A simplified and effective procedure for support of high-dose chemotherapy

High-dose chemotherapy with autologous peripheral brood progenitor cell (PB PC) support has become a widely used treatment strategy. In order to simpli fy the procedure, a single very large-volume leukapheresis programme combin ed with short-term refrigerated storage of the PBPC was developed. Seventy- two patients suffering from various relatively chemosensitive malignancies received high-dose chemotherapy, consisting of agents with short in vivo ha lf-lives and 24 to 48 hours Later, the refrigerated PBPC were reinfused. A single very large-volume apheresis was sufficient to obtain at least 2 x 10 (6)/kg CD34+ cells in 58 patients (81%), and 63% had at least 2.5 x 10(6) C D34+ cells/kg. Only two patients (3%) were transplanted with less than 1 x 10(6) CD34+ cells/kg. In three patients (4%) leukapheresis was repeated bec ause of insufficient number of PBPC. The median CD34+ cell count was 3 x 10 (6)/kg. A median of 38.5 L blood (range, 21 to 59) was processed, which acc ounted for a median of 9 x patient's total blood volume. Very large-volume leukapharesis was well tolerated with symptomatic hypocalcemia being the mo st common (18%) side-effect. The median time to neutrophils >1.5 x 10(9)/L, and to self-supporting platelet count >25 x 10(9)/L, was 10 and 12 days af ter reinfusion of PBPC graft, respectively. There were no treatment-related deaths. Our results indicate that this simplified approach of PBPC transpl antation can be associated with prompt hematologic recovery in most patient s and that it can be useful in settings where facilities are limited or for certain diseases where conditioning regimens with shea half-life are appro priate. J. Clin. Apheresis, 15:236-241, 2000. (C) 2000 Wiley-Liss, Inc.