Prospective evaluation of cell kinetics, yields and donor experiences during a single large-volume apheresis versus two smaller volume consecutive day collections of allogeneic peripheral blood stem cells

We report cell kinetics, yields and donation experiences of 20 demographically matched allogeneic peripheral blood stem cell (PBSC) donors who were prospectively assigned to undergo either a single 25 l or two consecutive daily 15 l (15 l x 2) apheresis procedures. Procedures were performed using prophylactic intravenous calcium administration after standard granulocyte colony-stimulating factor (GCSF) mobilization (10 mug/kg/d). Central line placements (two each), initial CD34 cell counts (0.077 vs 0.078 x 10(9) /l) and yields (7.9 vs 8.1 x 10(8) CD34 cells) were similar in the two groups; however, 25 l donors spent significantly less time both in the clinic (7.5 vs 10.8 h) and with central venous catheters in place (8.5 vs 29.5 h) than 15 l x 2 donors. End-procedure platelet counts were below 100 x 10(9)/l in one out of 10 25 l donors versus five out of 10 in 15 l x 2 donors (41%vs 53% mean decrease in platelet counts, P = 0.02). PBSC collection efficiency increased by 37% after 15 l of the 25-l volume had been processed, compared with no significant change during 15 l x 2 procedures. Results similar to these prospective findings were also observed in CD34 yields, symptoms and platelet counts in additional 25 l and 15 l procedures performed during the same period and evaluated retrospectively. This study indicates that a single 25-l apheresis procedure results in similar yields and symptoms, but less donor thrombocytopenia and inconvenience than two consecutive daily 15-l procedures.