Granulocyte transfusion (GTX) is a therapeutic option for severe bacterial or fungal infection in patients with sustained neutropenia after chemotherapy or stem cell transplantation. However, high molecular weight hydroxyethyl starch (HES), which has been used for selective sedimentation of red blood cells during apheresis, is not easily available in many countries including Japan. In this study, we evaluated the efficiency of granulocyte collection using medium molecular weight HES (130 kDa) in combination with the Spectra Optia apheresis system. Apheresis was performed for 2 consecutive days from seven donors and the mean total neutrophil yield from the first and second apheresis was 5.27 ± 3.10 × 1010 and 2.91 ± 2.92 × 1010, respectively. Infusion of concentrates from the first apheresis resulted in a significant neutrophil count increase and concentrates from the second apheresis were enough for maintenance of the neutrophil counts in all the recipients. Although the number of cases is limited, our results clearly show that sufficient number of granulocytes can be harvested by using medium molecular weight HES and this strategy is a safe and effective clinical practice in countries where high molecular weight HES is not available.

中文翻译：

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使用中等分子量的羟乙基淀粉成功进行粒细胞单采。

对于化学疗法或干细胞移植后持续中性粒细胞减少症患者的严重细菌或真菌感染，粒细胞输注（GTX）是一种治疗选择。然而，在包括日本在内的许多国家中，高分子量羟乙基淀粉（HES）一直被用于单采血液分离过程中的红细胞选择性沉淀。在这项研究中，我们评估了使用中等分子量的HES（130 kDa）结合Spectra Optia血液分离系统对粒细胞的收集效率。连续7天从7位捐献者处进行剖腹术，第一次和第二次单采血液分离术的平均嗜中性白细胞总产量分别为5.27±3.10×1010和2.91±2.92×1010。第一次单采血液浓缩液的注入导致嗜中性粒细胞计数显着增加，第二次单采血液浓缩液足以维持所有接受者的嗜中性白细胞计数。尽管病例数是有限的，但我们的结果清楚地表明，使用中等分子量的HES可收获足够数量的粒细胞，这种策略在没有高分子量HES的国家是一种安全有效的临床实践。