{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T05:56:36Z","timestamp":1764395796461,"version":"3.46.0"},"reference-count":7,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2025,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Autologous stem cell transplantation (\n ASCT<\/jats:styled-content>\n ) requires efficient collection of peripheral blood stem cells. At London Health Sciences Centre (\n LHSC<\/jats:styled-content>\n ), high\u2010risk multiple myeloma patients are routinely booked for three\u2010day apheresis collections to meet higher\n CD34<\/jats:styled-content>\n + cell count targets, though many do not require all scheduled days, leading to resource inefficiencies. A quality improvement initiative was implemented to reduce unnecessary apheresis sessions through two interventions: (1) lowering\n CD34<\/jats:styled-content>\n + cell count target thresholds (from 6\u2009\u00d7\u200910\n 6<\/jats:sup>\n to 5\u2009\u00d7\u200910\n 6<\/jats:sup>\n cells\/kg for tandem collections and from 3\u2009\u00d7\u200910\n 6<\/jats:sup>\n to 2.5\u2009\u00d7\u200910\n 6<\/jats:sup>\n for single collections), and (2) increasing total blood volume (\n TBV<\/jats:styled-content>\n ) processed from 3\u00d7 to 4\u00d7 for patients within certain target thresholds. Two Plan\u2010Do\u2010Study\u2010Act (\n PDSA<\/jats:styled-content>\n ) cycles were conducted between March 2024 and March 2025 involving 76 patients. Outcome measures included collection days saved and cost savings, and post\u2010transplant engraftment times served as a balancing measure. A total of 39.4% of patients avoided at least one collection day due to these interventions. Third\u2010day collection usage in high\u2010risk myeloma patients decreased from 25% to 5.9%. Mean collection days fell significantly in this group (2.21\u20131.8;\n p<\/jats:italic>\n \u2009=\u20090.0015), with total cost savings of\n CAD<\/jats:styled-content>\n $72\u2009734.97. No significant differences were observed in neutrophil or platelet engraftment times, confirming preserved clinical efficacy. Implementing lower\n CD34<\/jats:styled-content>\n + cell count targets and increased\n TBV<\/jats:styled-content>\n processing significantly reduced apheresis sessions and costs without compromising engraftment outcomes. These changes have become the standard of care at\n LHSC<\/jats:styled-content>\n and may serve as a feasible model for other transplant centers.\n <\/jats:p>","DOI":"10.1002\/jca.70066","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T12:31:56Z","timestamp":1761222716000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Streamlining Apheresis: A Dual\u2010Intervention Quality Improvement Initiative to Increase the Efficiency in Stem Cell Collection"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-8746","authenticated-orcid":false,"given":"Ivy E.","family":"Verriet","sequence":"first","affiliation":[{"name":"Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee","family":"Dickey","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, London Health Sciences Centre London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sue","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, London Health Sciences Centre London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"Schebesch","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, London Health Sciences Centre London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shona","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"},{"name":"Blood and Marrow Transplant Program, London Health Sciences Centre London Canada"},{"name":"Division of Hematology, Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anargyros","family":"Xenocostas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"},{"name":"Blood and Marrow Transplant Program, London Health Sciences Centre London Canada"},{"name":"Division of Hematology, Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9391-4204","authenticated-orcid":false,"given":"Uday","family":"Deotare","sequence":"additional","affiliation":[{"name":"Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"},{"name":"Blood and Marrow Transplant Program, London Health Sciences Centre London Canada"},{"name":"Division of Hematology, Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"},{"name":"The Centre for Quality, Innovation and Safety, Department of Medicine, Schulich School of Medicine and Dentistry Western University London Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"volume-title":"The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies","year":"2018","author":"Carreras E.","key":"e_1_2_12_2_1"},{"issue":"1","key":"e_1_2_12_3_1","first-page":"78","article-title":"Optimizing Stem Cells Mobilization Strategies to Ameliorate Patient Outcomes: A Review of Guide\u2010 Lines and Recommendations","volume":"11","author":"Mohammadi S.","year":"2017","journal-title":"International Journal of Hematology\u2010Oncology and Stem Cell Research"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.10.013"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14016"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V86.10.3961.bloodjournal86103961"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V91.9.3148"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.01.037"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T05:51:44Z","timestamp":1764395504000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.70066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/jca.70066"],"URL":"https:\/\/doi.org\/10.1002\/jca.70066","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"type":"print","value":"0733-2459"},{"type":"electronic","value":"1098-1101"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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