Abstract：
BACKGROUND: Increasing indications for cellular therapy collections have stressed our healthcare system, with autologous collections having a longer than desired wait time until apheresis collection. This quality improvement initiative was undertaken to accommodate more patients within existing resources.
METHODS: Patients with multiple myeloma who underwent autologous peripheral blood stem cell collection from October 2022 to April 2023 were included. Demographic, mobilization, laboratory, and apheresis data were retrospectively collected from the medical record.
RESULTS: This cohort included 120 patients (49.2% male), with a median age of 60 years. All received G-CSF and 95% received pre-emptive Plerixafor approximately 18 hours pre-collection. Most (79%) had collection goals of at least 8 × 106/kg CD34 cells, with 63% over 70 years old having this high collection goal (despite 20 years of institutional data showing <1% over 70 years old have a second transplant). With collection efficiencies of 55.9%, 44% of patients achieved their collection goal in a single day apheresis collection. A platelet count <150 × 103/μL on the day of collection was a predictor for poor mobilization; among 27 patients with a low baseline platelet count, 17 did not achieve the collection goal and 2 failed to collect a transplantable dose.
CONCLUSIONS: With minor collection goal adjustments, 15% of all collection appointments could have been avoided over this 6-month period. Other strategies to accommodate more patients include mobilization modifications (Plerixafor timing or substituting a longer acting drug), utilizing platelet counts to predict mobilization, and modifying apheresis collection volumes or schedule templates.
METHODS: Patients with multiple myeloma who underwent autologous peripheral blood stem cell collection from October 2022 to April 2023 were included. Demographic, mobilization, laboratory, and apheresis data were retrospectively collected from the medical record.
RESULTS: This cohort included 120 patients (49.2% male), with a median age of 60 years. All received G-CSF and 95% received pre-emptive Plerixafor approximately 18 hours pre-collection. Most (79%) had collection goals of at least 8 × 106/kg CD34 cells, with 63% over 70 years old having this high collection goal (despite 20 years of institutional data showing <1% over 70 years old have a second transplant). With collection efficiencies of 55.9%, 44% of patients achieved their collection goal in a single day apheresis collection. A platelet count <150 × 103/μL on the day of collection was a predictor for poor mobilization; among 27 patients with a low baseline platelet count, 17 did not achieve the collection goal and 2 failed to collect a transplantable dose.
CONCLUSIONS: With minor collection goal adjustments, 15% of all collection appointments could have been avoided over this 6-month period. Other strategies to accommodate more patients include mobilization modifications (Plerixafor timing or substituting a longer acting drug), utilizing platelet counts to predict mobilization, and modifying apheresis collection volumes or schedule templates.
摘要：
背景：越来越多的细胞治疗适应症已经强调了我们的医疗保健系统，自体收集具有比期望的等待时间更长的时间，直到单采血液成分收集。开展这项质量改进计划是为了在现有资源范围内容纳更多患者。
方法：纳入2022年10月至2023年4月接受自体外周血干细胞采集的多发性骨髓瘤患者。人口统计,动员,实验室,和血液分离的数据是回顾性收集从医疗记录.
结果：该队列包括120名患者（49.2％为男性），平均年龄为60岁。所有患者均接受G-CSF，95％接受抢先Plerixa约18小时的预收集。大多数（79％）具有至少8×106/kgCD34细胞的收集目标，63％的70岁以上的人有这个高收集目标（尽管20年的机构数据显示<1％的70岁以上的人有第二次移植）。收集效率为55.9%，44%的患者在单日单采血液收集中实现了他们的收集目标。采集当天血小板计数<150×103/μL是动员不良的预测因子；在27例基线血小板计数低的患者中，17没有到达收集目标，2未能收集到可移植剂量。
结论：随着收集目标的微小调整，在这6个月的时间里，可以避免15%的收款预约。适应更多患者的其他策略包括动员修改（Plerixafor计时或替代长效药物），利用血小板计数来预测动员，和修改单采采集量或计划模板。
方法：纳入2022年10月至2023年4月接受自体外周血干细胞采集的多发性骨髓瘤患者。人口统计,动员,实验室,和血液分离的数据是回顾性收集从医疗记录.
结果：该队列包括120名患者（49.2％为男性），平均年龄为60岁。所有患者均接受G-CSF，95％接受抢先Plerixa约18小时的预收集。大多数（79％）具有至少8×106/kgCD34细胞的收集目标，63％的70岁以上的人有这个高收集目标（尽管20年的机构数据显示<1％的70岁以上的人有第二次移植）。收集效率为55.9%，44%的患者在单日单采血液收集中实现了他们的收集目标。采集当天血小板计数<150×103/μL是动员不良的预测因子；在27例基线血小板计数低的患者中，17没有到达收集目标，2未能收集到可移植剂量。
结论：随着收集目标的微小调整，在这6个月的时间里，可以避免15%的收款预约。适应更多患者的其他策略包括动员修改（Plerixafor计时或替代长效药物），利用血小板计数来预测动员，和修改单采采集量或计划模板。
