Multiple myeloma patients receiving large volume leukapheresis efficiently yield enough CD34+ cells to allow double transplants

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...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of clinical apheresis Vol. 24; no. 1; pp. 6 - 11
Main Authors:	Zubair, A.C., Rymer, R., Young, J., Keeton, U., Befort, R., Nolot, B., Evans, C., Bleach, T., Torloni, A.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 2009
Subjects:	Adult Aged Antigens, CD34 Cost-Benefit Analysis Female Hematopoietic Stem Cell Mobilization - economics Hematopoietic Stem Cell Mobilization - methods Humans large volume leukapheresis Leukapheresis - economics Leukapheresis - methods Leukocyte Count Male Middle Aged multiple myeloma Multiple Myeloma - therapy Retrospective Studies stem cell collection Transplantation, Autologous
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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.
Bibliography:	ark:/67375/WNG-N90TCS4N-5 NIH - No. CA102824 istex:6B77BB740DB5A97905FE77630DAAA38760E833DA ArticleID:JCA20190 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0733-2459 1098-1101
DOI:	10.1002/jca.20190