P1331: CENTRAL AND PERIPHERAL VENOUS ACCESSES SHOW NO DIFFERENCES IN EFFICIENCY OF CD34 + CELLS COLLECTION BY APHERESIS

Abstract

Background: Cytokine-mobilized peripheral blood stem cells (PBSCs) are the most common source in autologous and allogenic hematopoietic stem cell transplantation (HSCT) at present, displacing bone marrow harvest. Through apheresis we can obtain PBSCs, process that may be performed by different types of vascular accesses, either peripheral veins (PV) or central venous catheter (CVC). Nowadays there is no consensus on the superiority of one access over another in terms of quality of harvesting. Aims: The goal of this study is to compare both techniques in order to discover differences between them in the scope of efficiency. Methods: Our single-center study retrospectively revised and compared 155 apheresis process performed between July/2016 and October/2021. We defined collection efficiency, as the CD34+ cellularity obtained in relation to the expected (according to the processed volemia and the CD34+ pre-apheresis cells concentration in blood determined on a flow cytometer). Haematocrit, leukocytes, platelets and total proteins were compared in both groups to rule out differences, since several studies have shown that can influence in the collection efficiency. In our study CVC employed were Shaldon or Hickman. Results: Of 155 apheresis, 71 (45.81%) were performed through CVC, and 84 (54.19%) through PV. We also divided our sample according to sex and pathology (“sample” of Table 1). Differences in Haematocrit, leukocytes, platelets and total proteins are also showed at “pre-apheresis results” in Table 1. Finally, we focused in post-apheresis data. We analyzed: the efficiency of the procedure, the volume of collected product and the final count of CD34+ collected. We also analyzed the possible differences between both groups of patients, using the Student’s T technique, looking for statistically significant differences (p) between them (“post-apheresis results” of Table 1). Image:Summary/Conclusion: The results of our study reveal a similar efficiency regardless of the type of access used for apheresis. Therefore, taking into account the possible complications of central catheter venous access, as a higher rate of infection, thrombosis, pneumothorax, bleeding or the recirculation rate risk, it should be used only in patients with poor peripheral accesses.