Comparison of Hematopoietic Progenitor Cell Collections Using the COBE Spectra Version 7 and Amicus Version 3.1 for Patients with AL Amyloidosis

To address concerns about infused fluid volume during HPC collections in patients with AL amyloidosis, our institution has used a 26:1 anticoagulant (AC) ratio on the COBE Spectra and on the Fenwal Amicus. In this study, in a cohort of AL amyloid patients, we compared the Amicus version 3.1 to the Spectra version 7 MNC collections with regard to infused fluid volume, CD34+ cell yield, lymphocyte yield, cross-cellular content, and adverse reactions. Both instruments used a 26:1 AC ratio but the Amicus delivered significantly less AC per procedure (Amicus 678 mL vs. Spectra 753 mL). With comparable baseline CD34+ cell counts (Amicus 33 cells/mu L vs. Spectra 27 cells/mu L); Amicus collected significantly more CD34+ cells (3.1 vs. 1.5 X 10(6)/kg) and equivalent lymphocytes (18.7 vs. 14.5 X 10(9)). Amicus collected significantly fewer WBC (51.8 vs. 72.7 X 10(9)), granulocytes (15.1 vs. 27.5 X 10(9)), and PLT (2.3 vs. 3.9 X 10(11)) per procedure with equivalent RBC content (26 vs. 30 mL). CD34+ cell (5.0 vs. 4.4 X 10(6)/kg) and lymphocyte doses (32.7 vs. 33.9 X 10(9)) were equivalent in infused products collected on the Amicus and Spectra but the frequency of high volume products was lower for Amicus. Frequency and severity of adverse reactions during collection and infusion were similar for both. In this group of AL amyloid patients, Amicus was superior to Spectra with regard to fluid infused, CD34+ cell yield, and cross-cellular contamination with equivalent lymphocyte yield and reaction incidence. J. Clin. Apheresis 26:186-194, 2011. (C) 2011 Wiley-Liss, Inc.