BACKGROUND: The COBE Spectra AutoPBSC collection set (AUTO-kit; CaridianBCT) is a popular dual-stage collection set for peripheral blood progenitor (PBPC) collection. Although the AUTO-kit is purportedly equivalent to the white blood cell (WBC) collection set (WBC-kit) for PBPC collection, improved CD34 yields after switching from the AUTO-kit to the WBC-kit were anecdotally observed, particularly in patients with higher WBC counts. A prospective, randomized trial of the AUTO- and WBC-kits for PBPC collection in multiple myeloma (MM) patients was therefore designed. STUDY DESIGN AND METHODS: Sixty-eight MM patients were prospectively randomly assigned to either the WBC-kit or the AUTO-kit for PBPC collection. Primary study variables included the number of leukapheresis procedures per transplant, CD34/kg yield per procedure, and cumulative CD34/kg yield per mobilization cycle. Results were compared relative to collection kit and mobilization regimen. Statistics and graphics were performed with commercial software. RESULTS:CD34/kg yields were higher with the WBC-kit, with 94% of chemotherapy-mobilized MM patients collecting 6 million CD34/kg in a single mobilization (p = 0.06). The WBC-kit also had a faster CD34 collection rate relative to peripheral CD34 counts. The AUTO-kit was significantly sensitive to high WBC counts, with a 50% decrease in CD34 collection efficiency and CD34 collection rate. This effect was specific to MM and not observed in lymphoma patients. Granulocyte-colony-stimulating factor mobilization and the AUTO-kit were associated with an increased incidence and severity of infusion reactions. CONCLUSIONS: The WBC-kit performed consistently better than the AUTO-kit for PBPC collection in chemotherapy-mobilized MM patients, with fewer procedures per mobilization, superior collection rates, and a decreased incidence of infusion reactions.
RCT Entities:
BACKGROUND: The COBE Spectra AutoPBSC collection set (AUTO-kit; CaridianBCT) is a popular dual-stage collection set for peripheral blood progenitor (PBPC) collection. Although the AUTO-kit is purportedly equivalent to the white blood cell (WBC) collection set (WBC-kit) for PBPC collection, improved CD34 yields after switching from the AUTO-kit to the WBC-kit were anecdotally observed, particularly in patients with higher WBC counts. A prospective, randomized trial of the AUTO- and WBC-kits for PBPC collection in multiple myeloma (MM) patients was therefore designed. STUDY DESIGN AND METHODS: Sixty-eight MMpatients were prospectively randomly assigned to either the WBC-kit or the AUTO-kit for PBPC collection. Primary study variables included the number of leukapheresis procedures per transplant, CD34/kg yield per procedure, and cumulative CD34/kg yield per mobilization cycle. Results were compared relative to collection kit and mobilization regimen. Statistics and graphics were performed with commercial software. RESULTS:CD34/kg yields were higher with the WBC-kit, with 94% of chemotherapy-mobilized MMpatients collecting 6 million CD34/kg in a single mobilization (p = 0.06). The WBC-kit also had a faster CD34 collection rate relative to peripheral CD34 counts. The AUTO-kit was significantly sensitive to high WBC counts, with a 50% decrease in CD34 collection efficiency and CD34 collection rate. This effect was specific to MM and not observed in lymphomapatients. Granulocyte-colony-stimulating factor mobilization and the AUTO-kit were associated with an increased incidence and severity of infusion reactions. CONCLUSIONS: The WBC-kit performed consistently better than the AUTO-kit for PBPC collection in chemotherapy-mobilized MMpatients, with fewer procedures per mobilization, superior collection rates, and a decreased incidence of infusion reactions.
Authors: Nandita Khera; Jack Jinneman; Barry E Storer; Shelly Heimfeld; Megan M O'Meara; Thomas R Chauncey; Stephanie J Lee; Michael Linenberger Journal: Biol Blood Marrow Transplant Date: 2011-06-15 Impact factor: 5.742
Authors: S Sinha; D Gastineau; I Micallef; W Hogan; S Ansell; F Buadi; D Dingli; A Dispenzieri; M Gertz; C Greiner; S Hayman; D Inwards; P Johnston; M Lacy; M Litzow; L Porrata; J L Winters; S Kumar Journal: Bone Marrow Transplant Date: 2010-10-11 Impact factor: 5.483