Original article

Vol. 22 No. 2 (2024): Blood Transfusion 2-2024 (March-April)

Collection efficiency of mononuclear cells in offline extracorporeal photopheresis: can processing time be shortened?

Authors

Key words: flow cytometry, collection efficiency, photopheresis, graft vs host disease, mononuclear cells
Publication Date: 2023-07-14

Abstract

Background - Extracorporeal photopheresis (ECP) is a well-established but lengthy and burdensome cell-based therapy for various diseases such as cutaneous T-cell lymphoma, graft-versus-host disease and organ rejection after transplantation. The number of mononuclear cells (MNCs) that needs to be collected to obtain a clinical response to ECP is still under debate. The purpose of this retrospective study was to determine the number of lymphocytes, monocytes and neutrophils in mononuclear cell products (MCP) by flow cytometry and the collection efficiency in the offline ECP setting.
Materials and methods - We collected data from 10 different patients undergoing 162 ECP procedures using the Spectra Optia device for MNC collection. White blood cell (WBC) count of MCP was determined using a hematology analyzer. MNCs were analyzed for CD45 and CD14 expression by flow cytometry to exactly determine the collected lymphocyte and monocyte fractions.
Results - Collected MCP showed high cell yields with 55.3×106/kg MNCs and 41.1×106/kg lymphocytes. MCP were characterized by high MNC (81.3%) and low neutrophils (18.7%) percentage. Mean collection efficiency for WBCs and for MNCs was 23.9% and 62.0%, respectively. The MNC fraction showed a moderate to high correlation between peripheral blood cell count of patients and MCP count.
Discussion - This study is one of a few reports showing the monocyte-to-lymphocyte relation in MCP for ECP determined by flow cytometry. In comparison to historical data from inline ECP, the offline ECP processing one total blood volume results in considerably higher cell yields. For this reason, and to reduce the burden on patients, we propose that the offline ECP processing time can be substantially reduced.

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Authors

Orkan Kartal - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

Nadja Lindlbauer - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

Sandra Laner-Plamberger - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria https://orcid.org/0000-0002-1416-6023

Eva Rohde - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria https://orcid.org/0000-0001-8692-886X

Fabian Föttinger - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

Laura Ombres - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

Georg Zimmermann - Team Biostatistics and Big Medical Data, IDA Lab, Paracelsus Medical University Salzburg, Salzburg, Austria; Research and Innovation Management, Paracelsus Medical University Salzburg, Salzburg, Austria

Cornelia Mrazek - Department of Laboratory Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

Lauth Wanda - Team Biostatistics and Big Medical Data, IDA Lab, Paracelsus Medical University Salzburg, Salzburg, Austria; Research and Innovation Management, Paracelsus Medical University Salzburg, Salzburg, Austria

Christoph Grabmer - Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

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