Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants
Version of Record online: 20 JAN 2009
Copyright © 2009 Wiley-Liss, Inc.
Journal of Clinical Apheresis
Volume 24, Issue 1, pages 6–11, 2009
How to Cite
Zubair, A.C., Rymer, R., Young, J., Keeton, U., Befort, R., Nolot, B., Evans, C., Bleach, T. and Torloni, A. (2009), Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants. J. Clin. Apheresis, 24: 6–11. doi: 10.1002/jca.20190
- Issue online: 2 FEB 2009
- Version of Record online: 20 JAN 2009
- Manuscript Accepted: 22 DEC 2008
- Manuscript Received: 29 JUL 2008
- NIH. Grant Number: CA102824
- stem cell collection;
- large volume leukapheresis;
- multiple myeloma
Current protocols for myeloma patients require more than one autologous transplant. We performed a retrospective study to determine the cost-effectiveness of large volume leukapheresis (LVL) compared with standard volume leukapheresis (SVL) collection when two transplants are required. We evaluated 87 patients who underwent a cumulative total of 260 LVL and SVL collections. The median product volume per collection was 356 ml for LVL, and this was significantly higher than the median product volume per collection for SVL (median 149.5 ml, P < 0.001). The median total CD34+ cell yield/kg was 6.4 × 106 for LVL and 5.2 × 106 for SVL. This difference was statistically significant (P = 0.005). Because the target CD34+ cell dose for a single transplant was 3 × 106/kg at our institution, overall the LVL yields enough CD34+ cells that could allow for two transplants. Therefore, more patients in the LVL group were able to undergo a potential second transplant. Because of the reserved cells for a second transplant, LVL patients received significantly less CD34+ cell/kg per transplant than the patients in SVL group (P = <0.001). As a result, LVL group had statistically significant but clinically insignificant delay in neutrophil (P = <0.001) and platelet (P = 0.02) engraftments. Additionally, using LVL instead of SVL to collect ≥6 × 106/kg CD34+ cells may potentially save $7,497 per patient. We therefore conclude that LVL is the method of choice for collection of multiple myeloma patients when two transplants are anticipated. J. Clin. Apheresis, 2009. © 2009 Wiley-Liss, Inc.