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dc.contributor.authorWeinstein, Robert
dc.contributor.authorKershaw, Glen
dc.contributor.authorBailey, Jeffrey A.
dc.contributor.authorGreene, Mindy
dc.contributor.authorChhibber, Vishesh
dc.contributor.authorVauthrin, Michelle
dc.contributor.authorNath, Rajneesh
dc.contributor.authorGalvin Karr, Eileen
dc.date2022-08-11T08:08:30.000
dc.date.accessioned2022-08-23T15:57:45Z
dc.date.available2022-08-23T15:57:45Z
dc.date.issued2014-04-01
dc.date.submitted2015-01-15
dc.identifier.citationJ Clin Apher. 2014 Apr;29(2):83-9. doi: 10.1002/jca.21295. Epub 2013 Aug 19. <a href="http://dx.doi.org/10.1002/jca.21295">Link to article on publisher's site</a>
dc.identifier.issn0733-2459 (Linking)
dc.identifier.doi10.1002/jca.21295
dc.identifier.pmid23959911
dc.identifier.urihttp://hdl.handle.net/20.500.14038/30275
dc.description.abstractAutologous hemopoietic progenitor cell (HPC) collection is the most frequent indication for an apheresis procedure in patients with multiple myeloma, up to 10% of whom may also require hemodialysis because of myeloma kidney. We investigated whether HPC collection could be performed in tandem with hemodialysis, to avoid extra outpatient visits for extracorporeal procedures, without compromising the efficacy of the hemodialysis, the HPC collection efficiency (CE) or patient safety. Four dialysis-dependent patients with multiple myeloma underwent 5 large volume leukapheresis HPC collections in tandem with hemodialysis. Under our protocol, all of the blood processed through the apheresis instrument was dialyzed against a standard calcium-rich bath prior to being returned to the patient, therefore no supplemental calcium was needed. No significant changes in pulse rate (P = 0.625) or mean arterial pressure (P = 0.188) were noted between the start and end of the procedures. The patients exhibited no signs or symptoms of hypocalcemia or other adverse effects. Calculated urea reduction ratios ranged between 62.5 and 73.9%, and HPC CE was between 53 and 84% for 4 of the 5 procedures, indicating that there was no compromise of either procedure when performed in tandem. Ionized calcium measured at the beginning, midpoint and end of every procedure did not change (P = 0.954). The two patients who proceeded to autologous HPC transplant engrafted on Days 11 and 10, respectively. We conclude that autologous HPC collection can safely be performed in tandem with hemodialysis without compromising the efficacy of dialysis, HPC CE, or patient safety.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=23959911&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1002/jca.21295
dc.subjectHematology
dc.subjectHemic and Lymphatic Diseases
dc.subjectNephrology
dc.subjectOncology
dc.subjectTherapeutics
dc.titleSafety and efficacy of autologous hemopoietic progenitor cell collection in tandem with hemodialysis in multiple myeloma with myeloma cast nephropathy
dc.typeJournal Article
dc.source.journaltitleJournal of clinical apheresis
dc.source.volume29
dc.source.issue2
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/528
dc.identifier.contextkey6532255
html.description.abstract<p>Autologous hemopoietic progenitor cell (HPC) collection is the most frequent indication for an apheresis procedure in patients with multiple myeloma, up to 10% of whom may also require hemodialysis because of myeloma kidney. We investigated whether HPC collection could be performed in tandem with hemodialysis, to avoid extra outpatient visits for extracorporeal procedures, without compromising the efficacy of the hemodialysis, the HPC collection efficiency (CE) or patient safety. Four dialysis-dependent patients with multiple myeloma underwent 5 large volume leukapheresis HPC collections in tandem with hemodialysis. Under our protocol, all of the blood processed through the apheresis instrument was dialyzed against a standard calcium-rich bath prior to being returned to the patient, therefore no supplemental calcium was needed. No significant changes in pulse rate (P = 0.625) or mean arterial pressure (P = 0.188) were noted between the start and end of the procedures. The patients exhibited no signs or symptoms of hypocalcemia or other adverse effects. Calculated urea reduction ratios ranged between 62.5 and 73.9%, and HPC CE was between 53 and 84% for 4 of the 5 procedures, indicating that there was no compromise of either procedure when performed in tandem. Ionized calcium measured at the beginning, midpoint and end of every procedure did not change (P = 0.954). The two patients who proceeded to autologous HPC transplant engrafted on Days 11 and 10, respectively. We conclude that autologous HPC collection can safely be performed in tandem with hemodialysis without compromising the efficacy of dialysis, HPC CE, or patient safety.</p>
dc.identifier.submissionpathfaculty_pubs/528
dc.contributor.departmentDepartment of Medicine, Division of Hematology/Oncology
dc.contributor.departmentDepartment of Medicine, Division of Transfusion Medicine
dc.source.pages83-9


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