Factors influencing platelet clumping during peripheral blood hematopoietic stem cell collection

Gagan Mathur; Sarah L Mott; Laura Collins; Gail A Nelson; C Michael Knudson; Annette J Schlueter

doi:10.1111/trf.14022

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Factors influencing platelet clumping during peripheral blood hematopoietic stem cell collection

Journal article

Open access

Peer reviewed

Factors influencing platelet clumping during peripheral blood hematopoietic stem cell collection

Gagan Mathur, Sarah L Mott, Laura Collins, Gail A Nelson, C Michael Knudson and Annette J Schlueter

Transfusion (Philadelphia, Pa.), Vol.57(5), pp.1142-1151

05/2017

DOI: 10.1111/trf.14022

PMCID: PMC5769924

PMID: 28150319

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https://doi.org/10.1111/trf.14022View

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Abstract

Platelet clumping is a common occurrence during peripheral blood hematopoietic stem cell (HSC) collection using the Spectra Optia mononuclear cell (MNC) protocol. If clumping persists, it may prevent continuation of the collection and interfere with proper MNC separation. This study is the first to report the incidence of clumping, identify precollection factors associated with platelet clumping, and describe the degree to which platelet clumping interferes with HSC product yield. In total, 258 HSC collections performed on 116 patients using the Optia MNC protocol were reviewed. Collections utilized heparin in anticoagulant citrate dextrose to facilitate large-volume leukapheresis. Linear and logistic regression models were utilized to determine which precollection factors were predictive of platelet clumping and whether clumping was associated with product yield or collection efficiency. Platelet clumping was observed in 63% of collections. Multivariable analysis revealed that a lower white blood cell count was an independent predictor of clumping occurrence. Chemotherapy mobilization and a lower peripheral blood CD34+ cell count were predictors of the degree of clumping. Procedures with clumping had higher collection efficiency but lower blood volume processed on average, resulting in no difference in collection yields. Citrate toxicity did not correlate with clumping. Although platelet clumping is a common technical problem seen during HSC collection, the total CD34+ cell-collection yields were not affected by clumping. WBC count, mobilization approach, and peripheral blood CD34+ cell count can help predict clumping and potentially drive interventions to proactively manage clumping.

Predictive Value of Tests

Antigens, CD34 - analysis

Hematopoietic Stem Cell Mobilization - methods

Humans

Middle Aged

Male

Leukapheresis - standards

Platelet Aggregation

Young Adult

Adolescent

Adult

Female

Leukocytes, Mononuclear - cytology

Aged

Leukapheresis - methods

Retrospective Studies

Details

Title: Subtitle: Factors influencing platelet clumping during peripheral blood hematopoietic stem cell collection
Creators: Gagan Mathur - Department of Pathology, University of Iowa
Sarah L Mott - Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
Laura Collins - Department of Pathology, University of Iowa
Gail A Nelson - Department of Pathology, University of Iowa
C Michael Knudson - Department of Pathology, University of Iowa
Annette J Schlueter - Department of Pathology, University of Iowa
Resource Type: Journal article
Publication Details: Transfusion (Philadelphia, Pa.), Vol.57(5), pp.1142-1151
DOI: 10.1111/trf.14022
PMID: 28150319
PMCID: PMC5769924
NLM abbreviation: Transfusion
ISSN: 0041-1132
eISSN: 1537-2995
Publisher: United States
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 05/2017
Academic Unit: Pathology; Radiation Oncology
Record Identifier: 9984046917802771

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