ABSTRACT
Peripheral blood progenitor cells [PBSC] have been extensively used to restore haematopoiesis after myeloablative chemotherapy. Large volume leukapheresis [LVL] was defined as the processing of greater than 3 volumes of blood at one setting, by which more hematopoietic progenitor cells are mobilized to the peripheral blood. The aim of this work was to study the effect the use of large and small apheresis techniques on stem cell yield in patients undergoing autologous PBSC transplantation. In this study 41 PBSC transplant patients were evaluated to assess the effect of use of small and large volume apheresis techniques on the transplantation process. The study included 17/41 cancer breast cases, 22/41 lymphoma cases and 2/41 leukemia patients. Small volume apheresis was performed in 9/41 [22%] of patients for whom 33 sessions of apheresis were performed while large volume apheresis technique was used in 32/41 [78%] of patients in 60 apheresis sessions. Comparing the outcome of these techniques showed that patients subjected to large blood volume apheresis technique showed a significantly higher mean yield when compared to small blood volume apheresis, [p<0.05]. Assessment of relation between number of mobilizations needed for the patient and chemotherapy potency revealed significant relation as heavily treated patients needed more mobilization rounds [p<0.05]. Yield of CD34 positive cells was affected by the number of mobilization rounds. Patients who needed a single round of mobilization showed a significant higher stem cell yield than with 2 rounds of mobilization [P.<0.01].Correlation study in this work revealed significant positive correlation between CD34+ cell yield [CD34+ cells x 10[6]/kg] and absolute CD34+ cell number in peripheral blood before harvest [precount] using the large volume technique with [r value = 0.87] and [p value < 0.01] while this significant correlation was not detected using small volume technique. Another significant positive correlation was found between CD34+ cell yield [CD34+ cells x 10[6]/kg] and the volume of blood processed during apheresis [r value=0.57] and [p<0.05]. Comparing the blood picture counts before and after harvesting using the large volume techniques, there was a significant difference between preharvest and postharvest mean hemoglobin and hematocrit [P <0.05 for each]. Assessment of effect of small volume on pre and postharvest blood picture counts revealed no significant difference between any of the counts before and after harvesting