Successful granulocyte apheresis using medium molecular weight hydroxyethyl starch
Granulocyte transfusion (GTX) is a therapeutic option for severe bacterial or fungal infection in patients with sustained neutropenia after chemotherapy or stem cell transplantation. However, high molecular weight hydroxyethyl starch (HES), which has been used for selective sedimentation of red blood cells during apheresis, is not easily available in many countries including Japan. In this study, we evaluated the efficiency of granulocyte collection using medium molecular weight HES (130 kDa) in combination with the Spectra Optia apheresis system. Apheresis was performed for 2 consecutive days from seven donors and the mean total neutrophil yield from the first and second apheresis was 5.27 ± 3.10 × 1010 and 2.91 ± 2.92 × 1010, respectively. Infusion of concentrates from the first apheresis resulted in a significant neutrophil count increase and concentrates from the second apheresis were enough for maintenance of the neutrophil counts in all the recipients. Although the number of cases is limited, our results clearly show that sufficient number of granulocytes can be harvested by using medium molecular weight HES and this strategy is a safe and effective clinical practice in countries where high molecular weight HES is not available.
KeywordsGranulocyte transfusion Apheresis Hydroxyethyl starch (HES)
Advice and comments given by Miya Araki (senior clinical trainer of TERUMO BCT) has been a great help in preparing this manuscript. This research is partly supported by KAKENHI Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (18K08354 to H.H. and 16K07171 to T.M.), Highway Program for Realization of Regenerative Medicine (JP17bm0504008 to H.H.) and the Acceleration of Transformative research for Medical innovation (ACT-MS) from Japan Agency for Medical Research and Development (AMED) (to H.H.).
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Conflict of interest
H.H. received research funding from Kyowa Hakko Kirin and Novartis Pharma. I.K. received research funding from Novartis Pharma. J.M.R is an employee of Terumo BCT. A.T-K received financial interests from Bristol-Meyers Squibb K.K, Celgene and Novartis Pharma. T.M. received research funding from Bristol-Meyers Squibb K.K. The remaining authors declare no conflicting financial interests.
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