Comparison of the Terumo BCT MNC and Cmnc Protocols for Peripheral Blood Stem Cell Collections

Abstract

Abstract Background: Terumo BCT recently offered a new method of peripheral blood stem cell (PBSC) collection using the Spectra Optia¨, an apheresis instrument. The new protocol includes a continuous mononuclear cell collection (CMNC) as opposed to an older version, the mononuclear cell collection (MNC), which involves an additional step where product pools through a cell separation insert. Our institution has used both methods and the purpose of this study was to compare the CMNC to the MNC protocol, including run times and PBSC product characteristics. Methods: A retrospective review and comparison of parameters from 120 collection procedures using the MNC insert and 60 collection procedures using the CMNC insert was done using the t-test. Data from patients/donors (including 20 allogeneic donors) as well as procedure details including run time, flow cytometry marker for stem cells (CD34)-positive (CD34+) throughput, CD34+ collection efficiency (CE%), platelet loss (plt loss/total blood volume [TBV]), and collection product characteristics were included in the analysis. Results: The MNC donor group included 12 allogeneic donors, which is comparable to the 8 allogeneic donors in the CMNC group. Donor weight and patient weight was not significantly different between the two groups. Pre-procedure laboratory values (WBC, percentage of lymphocytes [lymph%], percentage of monocytes [MNC%], and platelet count) were also similar between the two groups. Run time was found to be significantly shorter using the CMNC protocol compared to the MNC protocol. Product volume was also significantly lower in the CMNC group compared to the MNC group. Although the volume was lower, the CMNC product had significantly higher white blood cell count (WBC), MNC%, and lymph% when compared to the MNC product. The CD34+ throughput was significantly higher in the CMNC group than the MNC group. The CD34+ CE% was found to be slightly increased in the CMNC group, though not significantly. The platelet loss was nearly identical in both protocols when normalized for total blood volume. Product hematocrit (HCT%) was significantly higher using the CMNC protocol; however, the red blood cell volume never exceeded 20 mL due to the lower product volume with the CMNC protocol. The numerical results are summarized in the Table. Conclusion: The CMNC protocol collects a smaller volume of a purer product when compared to the MNC protocol with comparable platelet and red blood cell loss. Staff members who perform apheresis procedures are pleased by the shorter run time. Table Table. Disclosures Roig: Terumo BCT: Employment.