Maryam Razavi

maryam.razavi@cambio.se

@CambioCDS

To estimate the volume of whole blood to process by apheresis to yield an appropriate DLI dosage.

- Use to estimate the volume of allogeneic donor whole blood volume to process in order to achieve an appropriate DLI dose. - Patients who have received allogeneic stem cell transplants may be given donor lymphocyte infusions (DLI) as a means to augment/enhance the graft-versus-tumor effect. These cell therapy products are typically collected from the original donor of the hematopoietic progenitor cell used for the initial allograft. - DLI calculations rely on having a number of baseline clinical and laboratory values readily available from the donor, including the total white blood cell count and total lymphocyte percentage of the donor (typically obtained by automated CBC analysis), the percentage of total donor lymphocytes that are CD3+ T-cells (typically obtained by flow cytometry), as well as information needed about the recipient including their weight, the desired number of CD3+ cells/kg to be infused, and the number of doses to be infused; the latter two items are typically established by the recipient’s treating physician or transplant physician. - If flow cytometry data are not readily available, it is reasonable to estimate that the percentage of total donor lymphocytes that are CD3+ is 50%. - The calculation assumes a cellular collection efficiency of 50% by the apheresis instrument; this can vary somewhat from procedure-to-procedure. Formula: (A) Absolute CD3+ lymphocyte count, cells/mL = donor WBC x donor % total lymphocytes x donor % CD3+ lymphocytes x 1,000 (B) Total CD3+ cells needed = weight, kg x CD3+ infusion dose, cells/kg x number of doses desired (C) Total blood volume needed, L = (B / A) / collection efficiency Note: percents should be expressed as fractions, e.g. 30% total lymphocytes should be 0.30 in equation (A).

1. Wingard JR. Hematopoietic Stem Cell Transplantation, A Handbook for Clinicians. 2010.

OBSERVATION.body_weight.v2, OBSERVATION.donor_lymphocyte_infusion_dli_volume.v0