The world apheresis association registry, 2023 update

Update of data from the world apheresis association (WAA) registry

The WAA registry has been active since 2002. It allows bed side registration of safety and efficacy data. The data each center enters is accessible for its own use but also used for merged analysis. Most types of procedures are represented. Treatments of many severe diseases as well as the collection of autologous and donor cells for therapeutic use especially in oncologic diseases are recorded. Previous reports have shown a successive reduction in adverse events (AE) over the years. The aim of the present report is to update data of the risk for AE during the years from 2013 to Oct 2024. Contributions of 44 centers from 20 countries were analysed. Over these years, more than 169,000 apheresis procedures have been registered in more than 26,000 patients. During the study period the mean incidence of AE, merged for all types of procedures, was 1.6 /100 procedures for mild, 2.0/100 for moderate and 0.20/100 for severe AE, and reduced since 2013. Since 2002, death due to apheresis could not be excluded in one patient. There was an increased risk of hypotension during apheresis in patients with neurological diagnoses (ICD-10 chapter G) versus those with diseases of the musculoskeletal or connective tissue (ICD-10 chapter M) and vice versa for urticaria and tingling. In conclusion, the present data show the risk for various degrees of AE in apheresis procedures. Many patients suffer from severe illness and apheresis is often offered as a rescue therapy. Although the risk of death due to the apheresis procedure is extremely rare the concomitant severe disease itself poses a risk for severe events.

The Italian registry of therapeutic apheresis in SISTRA: Year of activity 2023

The Italian Registry of Therapeutic Apheresis (IRTA) collects clinical data on patients undergoing therapeutic apheresis procedures throughout the national territory, with the main objective of improving the quality and safety of the care provided to the patient. Given the importance of centralizing the collection and analysis of information on therapeutic apheresis, the National Blood Center (NBC), at the request of the Italian Scientific Society of Hemapheresis and Cellular Manipulation (SIdEM), has included IRTA in the Information System of Transfusion Services (SISTRA), which is the information system of the Ministry of Health for the exchange of data on blood and its derivatives between the Italian Regions and the NBC. This manuscript reports IRTA activity data for 2023 maintaining the general approach introduced in previous manuscripts to facilitate comparison with already published activity data (2020-2022). For each therapeutic apheresis procedure (more than 15) we reported the number of procedures, the number of patients treated, and adverse effects. Furthermore, for each pathology belonging to more than 8 specialized clinical areas we reported the number of procedures, the number of patients treated, the number of patients at first diagnosis and the outcome of the patients. More than 36000 procedures in more than 8500 patients were included in the 2023 database. The aim of the IRTA 2023 activity data is to provide an updated snapshot of the use of therapeutic apheresis in the treatment of human diseases in Italy and a strategic resource for institutions and scientific societies.

A multi-institutional survey of apheresis services among institutions in the United States

INTRODUCTION

Apheresis practices in the United States (US) have not been comprehensively characterized to date. This study aimed to address this gap by evaluating apheresis therapy through a national survey.

METHODS

A multi-institutional survey was conducted between April and July 2023. The survey, comprising 54 questions, focused on institutional demographics, procedures, equipment, staffing, training, and impacts of the Coronavirus Disease 2019 (COVID-19) pandemic. Responses from 22 institutions, primarily academic medical centers, were analyzed.

RESULTS

Therapeutic plasma exchange (TPE) was the most common procedure, followed by hematopoietic progenitor cell collection (HPC-A) and red blood cell exchange (RCE). CAR-T cell collections were widespread, with some institutions supporting over 30 protocols concurrently. Most sites used the Spectra Optia Apheresis System, were managed by a transfusion medicine service, and employed internal apheresis providers. Insufficient staffing levels, exacerbated by the COVID-19 pandemic, were common and most often addressed using overtime.

DISCUSSION

The survey highlighted the ubiquity of TPE, expanding cellular collections and staffing challenges. The role of apheresis in supporting cellular therapy, particularly in newly developing cell and gene therapies and clinical trials, was evident. Staffing issues during the pandemic emphasized the need for innovative recruitment strategies.

CONCLUSION

This nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.

Stem Cells Collection and Mobilization in Adult Autologous/Allogeneic Transplantation: Critical Points and Future Challenges

Achieving successful hematopoietic stem cell transplantation (HSCT) relies on two fundamental pillars: effective mobilization and efficient collection through apheresis to attain the optimal graft dose. These cornerstones pave the way for enhanced patient outcomes. The primary challenges encountered by the clinical unit and collection facility within a transplant program encompass augmenting mobilization efficiency to optimize the harvest of target cell populations, implementing robust monitoring and predictive strategies for mobilization, streamlining the apheresis procedure to minimize collection duration while ensuring adequate yield, prioritizing patient comfort by reducing the overall collection time, guaranteeing the quality and purity of stem cell products to optimize graft function and transplant success, and facilitating seamless coordination between diverse entities involved in the HSCT process. In this review, we aim to address key questions and provide insights into the critical aspects of mobilizing and collecting hematopoietic stem cells for transplantation purposes.