Impact of New Hematopoietic Progenitor Cell Collection Goals on Apheresis and Cell Therapy Laboratory Services

Abstract

In order to reflect patient needs given new treatment options for hematopoietic malignancies, autologous hematopoietic progenitor cell (HPC) collection goals were changed to 10 or 15 × 10⁶ CD34+/kg (previously 20 × 10⁶ CD34+/kg) for myeloma patients and to 5 × 10⁶ CD34+/kg (previously 10 × 10⁶ CD34+/kg) for lymphoma patients in March 2023. The minimum number of large volume leukapheresis (LVL) procedures required decreased from two to one. We analyzed the impact of these changes on apheresis and cell therapy laboratory (CTL) services. Data from the post-implementation period of April through December in 2023 were compared to those from the same 9-month periods in 2022 and 2021 as controls. The number of patients undergoing autologous HPC collection per month were examined. The numbers of LVL procedures, numbers of cryopreserved bags, and apheresis and CTL staffing hours and costs were determined retrospectively on a per patient and monthly basis. One-way ANOVA with Tukey's multiple comparison was performed. The per patient averages for LVL procedures, cryopreserved bags, staff hours, and costs in apheresis and CTL services were decreased significantly in 2023 compared to both control periods. However, for monthly analyses, differences were significant between 2023 and 2021; but not between 2023 and 2022. No differences were seen between the two control periods. The changes in autologous HPC collection goals led to a significant decrease in LVL procedures and cryopreserved bags required per patient to meet collection goals, reducing costs and workload for apheresis and CTL.

Keywords: HPC; cryopreserved products; large volume leukapheresis; workload cost savings.