Dr. Morad Mohrez (Regensburg/ DE), Dr. Andreas Michael Brosig (Regensburg/ DE), Dr. Irene Pamler (Regensburg/ DE), Ikram Tlili (Regensburg/ DE), Adelina Florina Bica (Regensburg/ DE), Ivana Treneva (Regensburg/ DE), Prof. Dr. Ralph Burkhardt (Regensburg/ DE), PD Dr. Robert Offner (Regensburg/ DE)
Background
Patients with impaired granulocyte function or sustained neutropenia after chemotherapy suffering from severe bacterial or fungal infections are routinely administered granulocyte concentrates. Ten years ago, we initiated the establishment and optimization of granulocytes apheresis using modified fluid gelatin 4% (MFG 4%) instead of hydroxyl ethyl starch (HES). This retrospective study is to present our compiled data since 2017.
Methods
796 granulocyte concentrates were obtained from 393 collections from male donors after mobilization with a single subcutaneous dose (480 µg) of granulocyte-colony-stimulating factor (G-CSF) and 8 mg of orally administered dexamethasone 10-12 hours before apheresis. Granulocyte collections were performed using a cell separator Spectra Optia IDL (Terumo BCT, PMN program) with MFG 4% as a sedimentation agent combined with ACD-A as an anticoagulant. Apheresis lasted around 150 min aiming to harvest at least 1x1010 or preferably 2x1010 granulocytes as the latter also implicates the possibility of splitting the product. Data were collected and analyzed retrospectively to show the effectiveness of MFG (4%) in granulocyte apheresis.
Results
393 granulocyte apheresates (GAs) with a mean concentration of 4,5x1010 (min. 1,0x1010; max. 12,9x1010) granulocytes per bag were collected from 01.01.2017 until the 30.04.2023. Interestingly, while 100% of the GAs have more than 1,0x1010 granulocytes per bag, 87,5% of the GAs contain more than 2,0 x1010 granulocytes per bag. According to the amount of harvested granulocytes and considering the number of patients to be treated with granulocytes, we were able to finally obtain 796 granulocyte products (GP) with a mean concentration of 2,2x1010 (min. 1,0x1010; max. 4,9x1010) granulocytes. Moreover, MFG (4%) did not induce any side effects in either donors or patients.
Conclusion
Our results clearly show that granulocytes can be collected successfully with MFG (4%), which represents an available alternative to classical HES. High-yield granulocyte collections allowed the splitting of the GAs; whereby 796 products were obtained from collections with MFG (4%) and transfused to their determined patients. The possibility of GAs splitting allows us to serve more than two fold of the patients. In addition, MFG provides a good safety profile for both donors and recipients.
Offenlegung Interessenkonflikt:
None.