Improved strategy for mononuclear cell collection for donor lymphocyte infusions.

BACKGROUND: To improve donor management for donor lymphocyte collections, a protocol was established to tailor the amount of whole blood processed during leukapheresis to achieve the requested cellular dose. STUDY DESIGN AND METHODS: A retrospective review of donor and product records of all donors who provided donor lymphocytes during the period October 27, 1999, to March 2, 2005, was performed (25 donors, 54 collections). Data on product total CD3+ T cells collected and total blood volume (TBV) processed were used to establish a correlation between the two variables. The resultant correlation from the reference group (8 donors, 13 collections) was then used to prospectively determine the TBV to be processed in a subsequent series of collections ("prospective group": 18 donors, 41 collections). Donor charts were also reviewed to determine leukapheresis-associated adverse events. RESULTS: The application of the correlation data between TBV processed and CD3+ T-cell yields from the initial reference group to the prospective group yielded 92 percent successful collections; in 3 of the 4 inadequate collections, the predefined maximum of three times their TBV was processed. Compared to the reference group, the TBV processed in the prospective group was decreased from 12,598+/-4007 to 7942+/-5079 mL; the length of procedure was decreased from 208+/-53 to 146+/-79 minutes. Adverse event data were reviewed for 51 collections; the percentage of procedures without adverse events increased from 23 percent in the reference group to 37 percent in the prospective group. CONCLUSION: Application of correlation data between TBV processed and CD3+ T-cell yield was useful to predict efficient and successful donor lymphocyte collections.

Duke Scholars

Author Beth H. Shaz Pathology