A prospective, randomized, sequential crossover trial oflarge‐volume versus normal‐volume leukapheresis procedures:effects on serum electrolytes, platelet counts, and other coagulation measures
- 1 March 2000
- journal article
- clinical trial
- Published by Wiley in Transfusion
- Vol. 40 (3), 368-374
- https://doi.org/10.1046/j.1537-2995.2000.40030368.x
Abstract
BACKGROUND: LVL procedures with the administration of heparin as an additional anticoagulant are increasingly performed because of the potentially higher yield of autologous peripheral blood HPCs. A prospective, randomized crossover trial was performed to evaluate the influence of leukapheresis volume—that is, large versus normal—on serum electrolytes, platelet count, and other coagulation measures in 25 patients with breast cancer and 14 patients with non-Hodgkin's lymphoma. STUDY DESIGN AND METHODS: Patients were randomly assigned to start either with an LVL on Day 1 followed by a normal-volume leukapheresis (NVL) on Day 2 or vice versa. In LVL, heparin was administered in addition to ACD-A. Bleeding complications, transfusion support, whole-blood counts, and several coagulation measures as well as plasma heparin levels were evaluated. RESULTS: Although the duration, the infused amount of ACD-A, the flow rate, the drop in platelet count, and the drop in potassium were significantly greater in LVL, and although LVL patients also received heparin, there was no significant difference in clinical tolerance or bleeding complications. After LVL, patients exhibited a significantly longer activated partial thromboplastin time (APTT), with a median of 70 seconds (range, 44–100 sec), and a median anti-factor Xa activity of 0.69 IU per mL (range, 0.10–1.29 IU/mL). The value of the APTT after LVL correlated with anti-factor Xa activity (r = 0.37, p<0.05), but not with platelet count or heparin infusion rate. Markers for coagulation activation did not increase during NVL or LVL. CONCLUSION: LVL with heparin as an additional anticoagulant seems to be a safe procedure in patients with low preleukapheresis platelet counts. No activation of coagulation occurred after NVL or LVL procedures.Keywords
This publication has 31 references indexed in Scilit:
- Nonparametric methods for paired samplesStatistica Neerlandica, 1999
- Peripheral blood progenitor cells for marrow reconstitution: mobilization and collection strategiesTransfusion, 1996
- Heparin: Mechanism of Action, Pharmacokinetics, Dosing Considerations, Monitoring, Efficacy, and SafetyChest, 1995
- Collection of mobilized blood progenitor cells for hematopoietic rescue by large‐volume leukapheresisTransfusion, 1995
- Large-volume leukapheresis for collection of mononuclear cells for hematopoietic rescue in Hodgkin's diseaseTransfusion, 1995
- Guidelines for the collection, processing and storage of human bone marrow and peripheral stem cells for transplantationTransfusion Medicine, 1994
- CD34+ progenitors and colony‐forming units‐granulocyte macrophage are recruited during large‐volume leukapheresis and concentrated by counterflow centrifugal elutriationTransfusion, 1993
- Large Volume Leukapheresis to Maximize Peripheral Blood Stem Cell CollectionJournal of Hematotherapy, 1993
- Large‐volume leukapheresis for peripheral blood stem cell collection in patients with hematologic malignanciesTransfusion, 1992
- Prothrombin fragment 1 + 2, thrombin–antithrombin III complexes and D‐dimers in acute deep vein thrombosis: effects of heparin treatmentBritish Journal of Haematology, 1991