Anticoagulation in large-volume leukapheresis: comparison between citrate- versus heparin-based anticoagulation on safety and CD34 + cell collection efficiency
| Autor: | Christoph Buchta, J.H. Maas, Alexander Strate, Helfried Wiesinger, Ying Chen, Markus Dettke |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Cancer Research Cd34 cells Metabolic alkalosis Antigens CD34 030204 cardiovascular system & hematology law.invention 0302 clinical medicine Randomized controlled trial law Immunology and Allergy Prospective Studies Large volume leukapheresis Genetics (clinical) Blood Volume Heparin Middle Aged 3. Good health Oncology Anesthesia Female Acidosis medicine.drug Adult medicine.medical_specialty Immunology Citric Acid Young Adult 03 medical and health sciences medicine Humans Leukapheresis Progenitor cell Blood Coagulation Aged Peripheral Blood Stem Cell Transplantation Transplantation business.industry Anticoagulants Cell Biology medicine.disease Chemokine CXCL12 Peripheral blood Blood Cell Count Surgery Leukocytes Mononuclear business 030215 immunology |
| Zdroj: | Cytotherapy. 14:350-358 |
| ISSN: | 1465-3249 |
| Popis: | Little is known of the effect of anticoagulation on peripheral blood progenitor cell (PBPC) harvest during large-volume leukapheresis (LVL). Because of the interaction of heparin with stromal cell-derived factor (SDF)-1α, it has been proposed that a heparin-based anticoagulation may result in an increased PBPC collection efficiency compared with standard citrate-based anticoagulation.We conducted a prospective randomized trial to address the effect of both anticoagulation regimes on safety, subjective comfort and CD34 (+) collection efficiency in 90 adult patients undergoing standardized LVL. Anticoagulation consisted of either citrate (group C) or a combination of heparin and low-dose citrate (group H).The overall incidence of adverse reactions (AR) during LVL was 17%. AR consisted only of citrate-related AR; no bleeding complications were observed. Determination of parameters of the acid-base balance revealed a higher frequency of metabolic alkalosis in group C. Analysis of serum SDF-1α revealed no differences in SDF-1α plasma levels. There were no differences in the CD34 (+) cell collection efficiency, resulting in the harvest of equal CD34 (+) cell yields independent of the anticoagulation used.Our data show no clinical relevant effect of a heparin containing anticoagulation in terms of an increased overall CD34 (+) cell collection during LVL, although this regime shows some benefits in terms of the incidence and subjective tolerance towards AR. Based on our results the decision between a citrate- and heparin-substituted anticoagulation for LVL should be driven by patient-related factors, and should concern potential contraindications of both methods. |
| Databáze: | OpenAIRE |
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