Combined heparin/acid citrate dextrose solution A anticoagulation in the Optia continuous mononuclear cell protocol for pediatric lymphocyte apheresis

J Clin Apher. 2019 Aug;34(4):487-489. doi: 10.1002/jca.21675. Epub 2018 Nov 29.


Collecting a sufficient number of T-cells is a critical first step in the production of chimeric antigen receptor (CAR)-T cells. Herein, we report a successful implementation of anticoagulation with combined heparin and acid citrate dextrose solution A (ACD-A) for the continuous mononuclear cell (CMNC) protocol on the Spectra Optia in a 20-month-old, 7.5 kg patient with refractory acute lymphoblastic leukemia for manufacture of tisagenlecleucel, a CAR-T cell therapy. Combined heparin/ACD-A was used following clotting issues when ACD-A was used alone during initial CMNC collections. To our knowledge, this is the first reported case in pediatrics of combined heparin/ACD-A anticoagulation with the Spectra Optia CMNC protocol.

Keywords: anticoagulation; chimeric antigen receptor-T cells; continuous mononuclear cell collection; pediatric apheresis.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / chemistry*
  • Child
  • Citric Acid*
  • Glucose / analogs & derivatives*
  • Heparin*
  • Humans
  • Immunotherapy, Adoptive
  • Infant
  • Leukapheresis / methods*
  • Leukocytes, Mononuclear
  • Pediatrics
  • T-Lymphocytes / cytology*


  • Anticoagulants
  • acid citrate dextrose
  • Citric Acid
  • Heparin
  • Glucose