Syed A. Abutalib - Best Practices of Apheresis in Hematopoietic Cell Transplantation

Advances and Controversies in Hematopoietic Transplantation and Cell Therapy

Series Editors

Syed A. Abutalib

Deerfield, Illinois, USA

James O. Armitage

Omaha, Nebraska, USA

Each volume will focus on different aspects of blood and marrow transplantation or cellular therapy and presents up-to-date data and concepts as well as controversial aspects.

More information about this series at http://www.springer.com/series/13907

Editors

Syed A. Abutalib , Anand Padmanabhan , Huy P. Pham and Nina Worel

Best Practices of Apheresis in Hematopoietic Cell Transplantation

Editors

Syed A. Abutalib

Cancer Treatment Centers of America, Dept Hematology & Bone Marrow Transplantation, Deerfield, IL, USA

Anand Padmanabhan

BloodCenter of Wisconsin, Milwaukee, WI, USA

Huy P. Pham

Department of Pathology, Keck School of Medicine of USC, Los Angeles, CA, USA

Nina Worel

Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria

ISSN 2569-1376 e-ISSN 2569-135X

Advances and Controversies in Hematopoietic Transplantation and Cell Therapy

ISBN 978-3-319-55130-2 e-ISBN 978-3-319-55131-9

https://doi.org/10.1007/978-3-319-55131-9

Springer Nature Switzerland AG 2020

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Contents

Anand Padmanabhan , Nina Worel , Huy P. Pham and Syed A. Abutalib

Joseph (Yossi) Schwartz and Jrg Halter

Dennis A. Gastineau and Kara K. Wacker

Laura S. Connelly-Smith

Nina Worel

Pavan Kumar Bhamidipati , Mark A. Fiala and John F. DiPersio

Edwin A. Burgstaler and Jeffrey L. Winters

Matthew S. Karafin and Mehraboon S. Irani

Michele Cottler-Fox

Gerda C. Leitner

Ammon Handisurya , Christof Aigner , Benjamin Schairer and Kurt Derfler

Georg Stussi , Andreas Buser and Andreas Holbro

Kristina Hlig and Hildegard Greinix

Marleen M. Neyrinck and Hans Vrielink

Mickey B. C. Koh , Senarath Banda Abeykoon Jayasekara and Rajeeka Lakmali Morawakage

With great pleasure, we present this inaugural edition of Best Practices of Apheresis in Hematopoietic Cell Transplantation as part of the handbook series on Advances and Controversies in Hematopoietic Cell Transplantation and Cellular Therapy. This project is a collaborative effort that spanned a time period of more than 2 years and included more than 20 experts, many whom are national leaders in their respected fields.

Hematopoietic progenitor cell (HPC) transplantation has been used increasingly in the treatment of both nonmalignant and neoplastic conditions. There are many critical steps to ensure a successful transplantation and obtaining an adequate amount of HPCs is one of them. Currently, HPCs can be obtained from related or unrelated donors (allogeneic HPC collections), the patient him/herself (autologous HPC collections), or cord blood. Similar to the source, there are various methods of obtaining HPCs. Typically, they are harvested either from the bone marrow or from the peripheral blood after mobilization. At this time, especially for the treatment of neoplastic diseases, the majority of HPCs are obtained from peripheral blood by apheresis due to the ease of collection and other clinical benefits for the donor/recipient discussed in the following chapters. Additionally, apheresis procedures may also be used to treat complications arising from allogeneic hematopoietic cell transplantation (allo-HCT), such as extracorporeal photopheresis (ECP) for the treatment of acute or chronic graft-versus-host disease, or in preparation of the patient for the transplant, such as therapeutic plasma exchange for recipients isoagglutinin reduction (in major mismatched) or red blood cell exchange for decreasing hosts red blood cells that would be the target for passenger lymphocyte syndrome (in minor mismatched) in patients undergoing ABO mismatched allo-HCT. Hence, apheresis plays an important role in the field of HCT. However, although the common goal is to get the patient to transplant, apheresis practices to achieve this goal may vary between institutions. This handbook seeks to provide readers with Best Practices in Apheresis with an emphasis on using this technique in the field of hematopoietic cell transplantation (HCT).

Since HPC product collections and HCT are highly regulated, this handbook begins with a chapter discussing various administrative and regulatory considerations. Accreditation by the Foundations for Accreditation in Cellular Therapy (FACT) or Joint Accreditation Committee ISCT and EBMT (JACIE) is an important benchmark of quality assurance used by many transplant programs; thus, a chapter on the topic of FACT/JACIE inspections and practical tips on how to avoid common citations is helpful and, therefore, is included. The next several chapters outline the process of donor selection and evaluations and different mobilization strategies commonly used in both allogenic and autologous transplant settings. A brief summary of the technical aspects and principles of different apheresis devices utilized in the collection process, including lymphocyte collection for donor lymphocyte collection (DLI), as well as information on cellular processing, such as in bone marrow harvests, along with prediction algorithms for HPC collection are provided. The remainder of the handbook discusses different apheresis procedures and their indications in the field of HPC transplantation. Specifically, anticoagulation and peri-procedural considerations are discussed along with different indications for the use of therapeutic plasma exchange/immunoadsorption, red blood cell exchange, and extracorporeal photopheresis. Furthermore, there are risks associated with apheresis procedures and thus, a chapter on how to recognize and provide care for apheresis complications is provided. Finally, recommendations and guidance on handling common challenges in apheresis medicine, such as in children or apheresis practice in a limited resource setting, are provided.