Improved peripheral blood stem cell collection following plasma exchange in a patient with elevated viscosity and coagulopathy

Jessie Alex; Yasuko O Erickson; Annette J Schlueter

doi:10.1002/jca.20154

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Improved peripheral blood stem cell collection following plasma exchange in a patient with elevated viscosity and coagulopathy

Journal article

Peer reviewed

Improved peripheral blood stem cell collection following plasma exchange in a patient with elevated viscosity and coagulopathy

Jessie Alex, Yasuko O Erickson and Annette J Schlueter

Journal of clinical apheresis, Vol.22(6), pp.339-341

2007

DOI: 10.1002/jca.20154

PMID: 18095304

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Abstract

We report a case of improved CD34+ cell yields from peripheral blood stem cell (PBSC) collection following therapeutic plasma exchange (TPE) in a patient with elevated viscosity and coagulopathy. The patient was a 46-year-old male diagnosed with IgM lambda multiple myeloma that was largely unresponsive to standard chemotherapy. He had coagulopathy due to lymphoproliferative disease-associated acquired von Willebrand Factor (vWF) deficiency. The patient underwent two rounds of PBSC collections over 3 consecutive weeks (five total collections) prior to planned tandem transplant for multiple myeloma. Both rounds resulted in poor collections due to processing difficulties. It was decided to perform three TPEs daily immediately prior to attempting additional PBSC collections, to treat the patient's elevated viscosity and thereby potentially improve the efficiency of collections. Immediately following the three TPEs, two additional PBSC collections resulted in sufficient CD34+ cells to proceed to transplant. Lower IgM and/or viscosity levels present after the three TPEs likely permitted successful collection of stem cells.

Plasmapheresis - methods

Viscosity

Antigens, CD34 - biosynthesis

Hematopoietic Stem Cell Mobilization - methods

Humans

Middle Aged

Blood Component Removal - methods

Male

Multiple Myeloma - immunology

Treatment Outcome

Immunoglobulin M - metabolism

Multiple Myeloma - therapy

Plasma Exchange - methods

Hematopoietic Stem Cells - cytology

Details

Title: Subtitle: Improved peripheral blood stem cell collection following plasma exchange in a patient with elevated viscosity and coagulopathy
Creators: Jessie Alex - DeGowin Blood Center, Department of Pathology, University of Iowa, Carver College of Medicine, Iowa City, Iowa 52242, USA
Yasuko O Erickson
Annette J Schlueter
Resource Type: Journal article
Publication Details: Journal of clinical apheresis, Vol.22(6), pp.339-341
Publisher: United States
DOI: 10.1002/jca.20154
PMID: 18095304
ISSN: 0733-2459
eISSN: 1098-1101
Language: English
Date published: 2007
Academic Unit: Pathology
Record Identifier: 9984047897702771

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