Background: The use of peripheral blood stem cells(PBSCs), an alternative
hematopoietic rescue product to bone marrow, is limited by the low progenitor cell
content of peripheral blood. To overcome this limitation, PBSCs mobilization with
cytotoxic chemotherapy and/or hematopoietic growth factors is used, but, in general,
multiple leukaphereses are still needed to collect an adequate number of PBSCs for
transplantation. Thus, to improve the usefullness of PBSCs, a more efficient collection
strategy is necessary.
Methods: PBSC collections were evaluated in 12 patients with acute leukemia in
complete remission who underwent large-volume leukapheresis(LVL) on a Fenwall
CS3000 Plus blood cell separator. Granulocyte colony-stimulating factor(G-CSF) was
administered subcutaneously(5㎍/㎏/day) after induction or consolidation chemotherapy.
Patients underwent leukaphereses designed to maximize PBSC yield(blood flow rate,
85mL/min).
Results: Thirty LVL procedures were done on twelve patients(mean 2.5, range, 1∼3).
Mean(±SD) volume processed was 20.0±0.4L at a single apheresis. The collection
volume was 131.7±28.6mL that contained 36.1mL of red blood cells. The mean
percentage of mononuclear cells(MNCs) was 97.1±7.4%, and the MNC collection
efficiency was 54.9±20.4%. The PBSC product per LVL contained a mean 3.39×
10 8MNCs/kg 6.82×10 6 CD34+ cells/㎏, and
6.08×10 4 CFU-GMs/kg, respectively. A mean of 2.5 leukaphereses resulted
in a mean of 8.21×10 8 MNCs/kg, 12.2×10 6 CD34+ cells/kg and 14.0×10 4 CFU-GMs/㎏, respectively. The phenotype
characterization of collected CD34+ cells showed that a mean of 94.2%
coexpressed HLA-DR, 97.1% coexpressed CD38. The percentage of CD34＋
/CD33＋ and CD34＋/c-kit＋ cells was
85.6% and 14.2%, respectively. Posta-pheresis hematocrit and platelets were reduced
from prepheresis value by 12.0%, and 53.5%, respectively. No adverse events were
related to the leukapheresis.
Conclusion : We conclude that large-volume leukapheresis, following chemotherapy
plus G-CSF, for patients with acute leukemia was tolerable, and allowed the collection
of adequate numbers of PBSC in a few procedures.

Keywords: Large-volume leukapheresis, Peripheral blood stem cell, Acute leukemia