Bojko P, Stellberg W, Küdde C, Scharifi M, Herrmann M, Mayer S, Harstrick A, Seeber S
Department of Internal Medicine, West German Cancer Center, Essen, Germany.
J Clin Apher. 1999;14(1):18-25. doi: 10.1002/(sici)1098-1101(1999)14:1<18::aid-jca4>3.0.co;2-#.
The impact of the separated volume on the yield of CD34+ cells during peripheral blood stem cell collections (PBSCC) remains controversial. We therefore studied the CD34+ cell concentration in the peripheral blood of patients (pts) during PBSCC as well as the total amount of CD34+ cells collected after each blood volume (BV) processed and engraftment data for each cycle of high dose chemotherapy (HD Ctx). A total of 21 PBSCC from 20 patients with different malignancies were analyzed. Stem cells were mobilized by chemotherapy and G-CSF (14 pts) or GM-CSF (6 pts). Samples from the pts peripheral blood and the collection bag were taken after each BV processed and analyzed for CD34+ cells, WBC, platelets (plt), and hemoglobin (Hb). The total volume processed was two to five times the pts calculated BV (mean value 17.4 L, range 9.0-24.0 L). Sixteen pts could be evaluated for engraftment. The mean peripheral blood CD34+ cell count was 116+/-103.5/microl at the start of PBSCC and decreased to 57+/-61.6/microl after processing of four times the pts BV. The mean number of CD34+ cells collected after each BV was 2.3+/-2.4, 5.8+/-5.2, 8.5+/-7.2, and 11.8+/-10.3x10(6) per kg body weight, respectively. The mean plt count decreased by 53+/-40.2/nl, Hb by 1.+/-0.5 g/dl and WBC by 0.+/-6.1/nl after separation of 4 BV. All but two pts reached the target value of 1.5x10(6) CD34+ cells/kg body weight and planned cycle of HD Ctx with 1 PBSCC. All pts engrafted and reached neutrophils>500/microl and plt>20,000/microl at a median of 11 and 13 days, respectively. We could demonstrate, that the yield of CD34+ cells during PBSCC increased continuously with the volume of the separated BV and that up to 5x the patients' BV could be processed safely without serious side effects. Most pts had to undergo only 1 PBSCC to collect sufficient numbers of CD34+ cells to support sequential courses of HD Ctx without delayed engraftment.
在外周血干细胞采集（PBSCC）过程中，分离体积对CD34+细胞产量的影响仍存在争议。因此，我们研究了PBSCC期间患者外周血中CD34+细胞的浓度，以及每次处理血量（BV）后采集的CD34+细胞总量和每个高剂量化疗（HD Ctx）周期的植入数据。对来自20例不同恶性肿瘤患者的21次PBSCC进行了分析。通过化疗和G-CSF（14例）或GM-CSF（6例）动员干细胞。在每次处理BV后采集患者外周血和采集袋中的样本，分析CD34+细胞、白细胞（WBC）、血小板（plt）和血红蛋白（Hb）。处理的总体积是患者计算BV的2至5倍（平均值17.4 L，范围9.0 - 24.0 L）。16例患者可评估植入情况。PBSCC开始时外周血CD34+细胞平均计数为116±103.5/μl，在处理4倍患者BV后降至57±61.6/μl。每次BV后采集的CD34+细胞平均数量分别为每千克体重2.3±2.4、5.8±5.2、8.5±7.2和11.8±10.3×10⁶。分离4次BV后，平均plt计数下降53±40.2/μl，Hb下降1.±0.5 g/dl，WBC下降0.±6.1/μl。除2例患者外，所有患者通过1次PBSCC均达到了每千克体重1.5×10⁶个CD34+细胞的目标值和HD Ctx的计划周期。所有患者均实现植入，分别在中位数11天和13天时中性粒细胞>500/μl和plt>20,000/μl。我们可以证明，PBSCC期间CD34+细胞的产量随分离BV的体积持续增加，并且可以安全地处理高达患者BV 5倍的血量而无严重副作用。大多数患者仅需进行1次PBSCC即可收集到足够数量的CD34+细胞，以支持HD Ctx的连续疗程且无植入延迟。
