Citrate Versus Citrate–Heparin Anticoagulation in HPC (A): Comparative Effects on Intra‐Apheresis Mobilization of CD34 + Hematopoietic Progenitor Cells
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Wiley
2026
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| author | Yandy Marx Castillo‐Aleman Carlos Agustin Villegas‐Valverde Antonio Alfonso Bencomo‐Hernandez Shinnette Lumame Charisma Castelo Jay Mary Rose‐Roque Marlene Cato Nameer Al‐Saadawi Mohamed Ibrahim Abu‐Haleeqa Aseel Suleiman Alsaid Sakher Ahmad Obeidat Mansi Sachdev Jayakumar David Dennison Inas El‐Najjar Rene Antonio Rivero‐Jimenez Yendry Ventura‐Carmenate Fatema Mohammed Al‐Kaabi |
| author_facet | Yandy Marx Castillo‐Aleman Carlos Agustin Villegas‐Valverde Antonio Alfonso Bencomo‐Hernandez Shinnette Lumame Charisma Castelo Jay Mary Rose‐Roque Marlene Cato Nameer Al‐Saadawi Mohamed Ibrahim Abu‐Haleeqa Aseel Suleiman Alsaid Sakher Ahmad Obeidat Mansi Sachdev Jayakumar David Dennison Inas El‐Najjar Rene Antonio Rivero‐Jimenez Yendry Ventura‐Carmenate Fatema Mohammed Al‐Kaabi Yandy Marx Castillo‐Aleman Carlos Agustin Villegas‐Valverde Antonio Alfonso Bencomo‐Hernandez Shinnette Lumame Charisma Castelo Jay Mary Rose‐Roque Marlene Cato Nameer Al‐Saadawi Mohamed Ibrahim Abu‐Haleeqa Aseel Suleiman Alsaid Sakher Ahmad Obeidat Mansi Sachdev Jayakumar David Dennison Inas El‐Najjar Rene Antonio Rivero‐Jimenez Yendry Ventura‐Carmenate Fatema Mohammed Al‐Kaabi |
| collection | Wiley Open Access |
| contents | Citrate Versus Citrate–Heparin Anticoagulation in HPC (A): Comparative Effects on Intra‐Apheresis Mobilization of CD34 + Hematopoietic Progenitor Cells Yandy Marx Castillo‐Aleman Carlos Agustin Villegas‐Valverde Antonio Alfonso Bencomo‐Hernandez Shinnette Lumame Charisma Castelo Jay Mary Rose‐Roque Marlene Cato Nameer Al‐Saadawi Mohamed Ibrahim Abu‐Haleeqa Aseel Suleiman Alsaid Sakher Ahmad Obeidat Mansi Sachdev Jayakumar David Dennison Inas El‐Najjar Rene Antonio Rivero‐Jimenez Yendry Ventura‐Carmenate Fatema Mohammed Al‐Kaabi Journal of Clinical Apheresis ABSTRACT Successful hematopoietic stem cell transplantation relies on the collection of a sufficient number of CD34 + hematopoietic progenitor cells (HPCs). While acid citrate dextrose solution A (ACD‐A) is a common anticoagulant (AC) for HPC apheresis [HPC(A)], recent evidence suggests that concomitant heparin may enhance intra‐apheresis recruitment (IAR) of CD34 + cells and improve collection efficiency. This study aimed to compare citrate‐only and citrate–heparin protocols in routine HPC(A) procedures, with a focus on their effects on IAR and efficiency outcomes. A retrospective analysis was performed on 266 HPC(As) from 193 apheresis donors in autologous and allogeneic settings. Donor demographics, procedural parameters, and collection outcomes were compared between the ACD‐A–only and ACD‐A plus heparin protocols. The study endpoints included apheresis yield (AY/kg), collection efficiencies (CE 1 , CE 2 , and cruCE), recruitment ratio (RR), and performance ratio (PR). Statistical analyses included Mann–Whitney U tests, effect sizes, and partial least squares (PLS) regression. Heparinized procedures demonstrated higher processed total blood volume ratios, lower AC volumes, and superior outcomes across CE 1 (83.8% vs. 72.5%, p = 0.00027), CE 2 (70.8% vs. 64.2%, p = 0.0055), cruCE (77.0% vs. 72.4%, p < 0.0001), RR (2.3 vs. 1.7, p < 0.0001), PR (239.3% vs. 208.2%, p < 0.0001), and AY/kg (6.75 vs. 5.23 × 10 6 CD34 + cells/kg, p = 0.0025). The effect size and PLS analyses confirmed the contribution of heparin as an adjunct AC enhancing multiple apheresis outcomes. In summary, citrate–heparin anticoagulation was found to be a feasible strategy that improved key collection efficiency and IAR metrics during HPC(A). 10.1002/jca.70118 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/jca.70118 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_jca_70118 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Citrate Versus Citrate–Heparin Anticoagulation in HPC (A): Comparative Effects on Intra‐Apheresis Mobilization of CD34 + Hematopoietic Progenitor Cells Yandy Marx Castillo‐Aleman Carlos Agustin Villegas‐Valverde Antonio Alfonso Bencomo‐Hernandez Shinnette Lumame Charisma Castelo Jay Mary Rose‐Roque Marlene Cato Nameer Al‐Saadawi Mohamed Ibrahim Abu‐Haleeqa Aseel Suleiman Alsaid Sakher Ahmad Obeidat Mansi Sachdev Jayakumar David Dennison Inas El‐Najjar Rene Antonio Rivero‐Jimenez Yendry Ventura‐Carmenate Fatema Mohammed Al‐Kaabi Journal of Clinical Apheresis Citrate Versus Citrate–Heparin Anticoagulation in HPC (A): Comparative Effects on Intra‐Apheresis Mobilization of CD34 + Hematopoietic Progenitor Cells Yandy Marx Castillo‐Aleman Carlos Agustin Villegas‐Valverde Antonio Alfonso Bencomo‐Hernandez Shinnette Lumame Charisma Castelo Jay Mary Rose‐Roque Marlene Cato Nameer Al‐Saadawi Mohamed Ibrahim Abu‐Haleeqa Aseel Suleiman Alsaid Sakher Ahmad Obeidat Mansi Sachdev Jayakumar David Dennison Inas El‐Najjar Rene Antonio Rivero‐Jimenez Yendry Ventura‐Carmenate Fatema Mohammed Al‐Kaabi Journal of Clinical Apheresis ABSTRACT Successful hematopoietic stem cell transplantation relies on the collection of a sufficient number of CD34 + hematopoietic progenitor cells (HPCs). While acid citrate dextrose solution A (ACD‐A) is a common anticoagulant (AC) for HPC apheresis [HPC(A)], recent evidence suggests that concomitant heparin may enhance intra‐apheresis recruitment (IAR) of CD34 + cells and improve collection efficiency. This study aimed to compare citrate‐only and citrate–heparin protocols in routine HPC(A) procedures, with a focus on their effects on IAR and efficiency outcomes. A retrospective analysis was performed on 266 HPC(As) from 193 apheresis donors in autologous and allogeneic settings. Donor demographics, procedural parameters, and collection outcomes were compared between the ACD‐A–only and ACD‐A plus heparin protocols. The study endpoints included apheresis yield (AY/kg), collection efficiencies (CE 1 , CE 2 , and cruCE), recruitment ratio (RR), and performance ratio (PR). Statistical analyses included Mann–Whitney U tests, effect sizes, and partial least squares (PLS) regression. Heparinized procedures demonstrated higher processed total blood volume ratios, lower AC volumes, and superior outcomes across CE 1 (83.8% vs. 72.5%, p = 0.00027), CE 2 (70.8% vs. 64.2%, p = 0.0055), cruCE (77.0% vs. 72.4%, p < 0.0001), RR (2.3 vs. 1.7, p < 0.0001), PR (239.3% vs. 208.2%, p < 0.0001), and AY/kg (6.75 vs. 5.23 × 10 6 CD34 + cells/kg, p = 0.0025). The effect size and PLS analyses confirmed the contribution of heparin as an adjunct AC enhancing multiple apheresis outcomes. In summary, citrate–heparin anticoagulation was found to be a feasible strategy that improved key collection efficiency and IAR metrics during HPC(A). 10.1002/jca.70118 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Citrate Versus Citrate–Heparin Anticoagulation in HPC (A): Comparative Effects on Intra‐Apheresis Mobilization of CD34 + Hematopoietic Progenitor Cells |
| topic | Journal of Clinical Apheresis |
| url | https://onlinelibrary.wiley.com/doi/10.1002/jca.70118 |