Abstract | BACKGROUND: Autologous stem cell transplants in patients with hemoglobinopathies are limited. Previous reports used granulocyte-colony-stimulating factor ( G-CSF) for mobilization of stem cells; there are no reported cases undergoing plerixafor mobilization. We report such a patient, providing guidance for peripheral blood stem cells collection when aberrant red blood cells (RBCs) disrupt normal separation. STUDY DESIGN AND METHODS: RESULTS: Collections were performed using an apheresis system, processing 24 L daily. Peripheral blood and apheresis product CD34 determinations were performed daily. On Day 1, the product yield was 0.04 × 10(6) CD34 cells/kg, less than expected based on white blood cell count and CD34-positive cells. Peripheral blood smear showed nucleated RBCs and RBC morphologic abnormalities. Changes in instrument variables were made after consultation with Terumo BCT to adjust for variable distribution of mononuclear and stem cells during centrifugation. Collecting stem cells at a deeper location and centrifuging faster improved collection, and a cumulative total of 4.40 × 10(6) CD34 cells/kg was achieved after four collections. The patient underwent tandem autologous transplantation and engrafted within 12 to 13 days of each transplant. CONCLUSIONS: Adjustments in apheresis variables allowed successful collection of peripheral blood stem cells from a patient with RBC anomalies of β- thalassemia that interfered with standard stem cell harvesting.
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Authors | Kimberly Sanford, Susan D Roseff, Jennifer Anderson, Harold M Chung, Richard A McPherson |
Journal | Transfusion
(Transfusion)
Vol. 54
Issue 7
Pg. 1881-6
(Jul 2014)
ISSN: 1537-2995 [Electronic] United States |
PMID | 24527966
(Publication Type: Case Reports, Journal Article)
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Copyright | © 2014 AABB. |
Chemical References |
- Granulocyte Colony-Stimulating Factor
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Topics |
- Animals
- Blood Component Removal
(methods, standards)
- Cell Separation
(methods, standards)
- Erythrocytes, Abnormal
- Granulocyte Colony-Stimulating Factor
- Hematopoietic Stem Cell Mobilization
- Hematopoietic Stem Cell Transplantation
- Hematopoietic Stem Cells
(cytology)
- Humans
- Male
- Middle Aged
- beta-Thalassemia
(blood, therapy)
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