From the Research
The minimum hemoglobin level typically recommended for peripheral blood mononuclear cell (PBMC) collection for CAR-T therapy is approximately 8 g/dL, or a hematocrit of about 24%. These thresholds are established to ensure patient safety during the apheresis procedure, which can cause temporary decreases in blood counts. Patients with hemoglobin levels below these thresholds may experience symptoms of anemia such as dizziness, fatigue, or shortness of breath during the collection process. For patients with borderline or low hemoglobin/hematocrit values, a red blood cell transfusion may be recommended prior to the apheresis procedure to increase these values to safer levels. The exact threshold may vary slightly between institutions and based on individual patient factors such as cardiovascular status, age, and comorbidities. The collection center's medical director may make case-by-case decisions for patients with values below these thresholds, weighing the urgency of cell collection against potential risks of proceeding with lower blood counts.
According to the most recent study 1, peripheral blood mononuclear cell therapy has shown promising results in the management of patients with diabetes and no-option critical limb ischemia, but it does not provide specific guidance on the minimum hemoglobin or hematocrit levels for PBMC collection. However, an earlier study 2 found that precollection hemoglobin was strongly associated with MNC yield, suggesting that higher hemoglobin levels may be beneficial for PBMC collection.
Key considerations for determining the minimum hemoglobin or hematocrit levels for PBMC collection include:
- Patient safety during the apheresis procedure
- Risk of anemia and related symptoms
- Individual patient factors such as cardiovascular status, age, and comorbidities
- Institution-specific guidelines and protocols
- The urgency of cell collection and potential risks of proceeding with lower blood counts.
In general, the decision to proceed with PBMC collection should be made on a case-by-case basis, taking into account the individual patient's condition and the potential benefits and risks of the procedure 3, 4, 5.