Although the therapeutic removal of blood components has dated back centuries, with records of therapeutic phlebotomy dating back to George Washington’s untimely death, modern leukapheresis dates back to the 1970’s with the introduction of filtration leukapheresis. This outdated method removed granulocytes, a phagocytic leukocyte outlined in LEUKAPHERESIS PRODUCTS, by a nylon fiber filter system that yielded a larger volume of cells than with centrifugation but with moderate functional impairment and increased vascular adverse reactions for the patient. Several cases of severe transient neutropenia, a condition with low neutrophil (a type of granulocyte outlined in LEUKAPHERESIS PRODUCTS) count, were reported only minutes after the patient’s blood came in contact with the nylon. These adverse reactions, not limited to intravascular recovery, prompted a discontinuation of the filtration system. Apheresis machines with intermittent and continuous blood flow became the norm with a unique partnership.
The collaboration of IBM and the National Cancer Institute (NCI) to treat patients with chronic myeloid leukemia led to the development of the first closed-loop centrifuge system, the Model 2997. Although precursor models like The NCI-IBM Blood Cell Separator, Aminco Celltrifuge, and the original Latham bowl for plateletpheresis saw success in the removal of granulocytes and platelet collection, these systems were made of multiple, reusable parts that needed to be continuously sterilized and reassembled. The Model 2997 simplified the process by using disposable, plastic materials for collection and separation and bridged the gap between “inflow” and “outflow” ports to form a closed loop. At this time, continuous and intermittent blood flow techniques were being utilized, but the closed-loop system allowed for a more efficient collection and led to the development of the IBM and COBE systems used today.
A cause and a machine were needed and IBM played a very important role in the accessibility of leukapheresis technology. Studies pertaining to the benefits of leukapheresis, specifically in populations of patients with leukemia and symptoms of leukostasis, quickly came to term during this time period while researchers and physicians were seeking logical answers to the persistent rise in the number of “bad” white blood cells. The original solution was to simply get rid of the bad cells in a safe, effective, and efficient manner but studies imminently showed that long term survival rates were not improved using leukapheresis alone. Researchers now are seeking more information related to a combination technique using the leukapheresis and volume replacement (LR-VR) procedure. This procedure increases the number of WBCs removed by allowing larger-than-normal blood volume to be removed with immediate replacement of thawed donor plasma.
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