BACKGROUND: The COBE Spectra AutoPBSC collection set (AUTO‐kit; CaridianBCT) is a popular dual‐stage collection set for peripheral blood progenitor (PBPC) collection. Although the AUTO‐kit is purportedly equivalent to the white blood cell (WBC) collection set (WBC‐kit) for PBPC collection, improved CD34 yields after switching from the AUTO‐kit to the WBC‐kit were anecdotally observed, particularly in patients with higher WBC counts. A prospective, randomized trial of the AUTO‐ and WBC‐kits for PBPC collection in multiple myeloma (MM) patients was therefore designed.
STUDY DESIGN AND METHODS: Sixty‐eight MM patients were prospectively randomly assigned to either the WBC‐kit or the AUTO‐kit for PBPC collection. Primary study variables included the number of leukapheresis procedures per transplant, CD34/kg yield per procedure, and cumulative CD34/kg yield per mobilization cycle. Results were compared relative to collection kit and mobilization regimen. Statistics and graphics were performed with commercial software.
RESULTS: CD34/kg yields were higher with the WBC‐kit, with 94% of chemotherapy‐mobilized MM patients collecting 6 million CD34/kg in a single mobilization (p = 0.06). The WBC‐kit also had a faster CD34 collection rate relative to peripheral CD34 counts. The AUTO‐kit was significantly sensitive to high WBC counts, with a 50% decrease in CD34 collection efficiency and CD34 collection rate. This effect was specific to MM and not observed in lymphoma patients. Granulocyte–colony‐stimulating factor mobilization and the AUTO‐kit were associated with an increased incidence and severity of infusion reactions.
CONCLUSIONS: The WBC‐kit performed consistently better than the AUTO‐kit for PBPC collection in chemotherapy‐mobilized MM patients, with fewer procedures per mobilization, superior collection rates, and a decreased incidence of infusion reactions.