de Fabritiis P, Gonzalez M, Meloni G, De Propris M S, Bellucci R, Cordone I, Gozzer M, Leone G, Mandelli F
Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Rome, Italy.
Bone Marrow Transplant. 1999 Jun;23(12):1229-36. doi: 10.1038/sj.bmt.1701798.
We have studied a total of 188 patients with hematological malignancies, submitted to mobilization therapy with G-CSF associated or not with chemotherapy in order to: (1) establish the lower limit of circulating progenitor cells that allows the collection of 2 x 10(6) CD34+ cells/kg by a single leukapheresis, utilizing the instrument set on standard parameters; (2) evaluate whether the number and quality of CD34+ cells collected remain stable during leukapheresis; and (3) collect a sufficient number of circulating CD34+ cells by a single procedure in patients in whom such an approach would have been insufficient to reach the target with the instrument set on standard parameters. The retrospective analysis conducted in 85 patients showed that 19 circulating CD34+ cells/microl represented the cut-off number capable of discriminating between patients who will require one or more apheresis to collect 2 x 10(6) CD34+ cells/kg. The validity of this value was prospectively confirmed in 70 subsequent patients. Based on in vitro results that showed the stability in the number of CD34+ cells, the proportion of different CD34+ cell subpopulations and the clonogenic capacity of the stem cell compartment during leukapheresis both in the blood of the patients and in samples taken directly from the instrument, we have adapted the blood volume to be processed in 33 patients with <19 PB CD34+ cells/microl. Stem cell collection was monitored during the leukapheresis and the procedure was prolonged for a time period estimated to be sufficient to reach the target number of CD34+ cells with a single procedure. The median increment of the total blood volume processed, calculated from the volume set automatically by the instrument was 25.2%, with a median of 3.3-fold total blood volume processed. In all cases, a sufficient CD34+ cell collection was completed in a single procedure. After autograft, the pattern of blood reconstitution was similar to that of all the other patients.
我们共研究了188例血液系统恶性肿瘤患者，这些患者接受了粒细胞集落刺激因子（G-CSF）动员治疗，联合或不联合化疗，目的如下：（1）确定循环祖细胞的下限，以便在仪器设置为标准参数的情况下，通过单次白细胞分离术采集2×10⁶个CD34⁺细胞/kg；（2）评估在白细胞分离术期间采集的CD34⁺细胞的数量和质量是否保持稳定；（3）对于那些采用标准参数设置的仪器无法通过单次操作达到目标的患者，通过单次操作采集足够数量的循环CD34⁺细胞。对85例患者进行的回顾性分析表明，每微升19个循环CD34⁺细胞代表了一个临界值，能够区分出那些需要进行一次或多次单采术才能采集到2×10⁶个CD34⁺细胞/kg的患者。随后在70例患者中前瞻性地证实了该值的有效性。基于体外结果显示，在白细胞分离术期间，患者血液和直接从仪器采集的样本中，CD34⁺细胞数量、不同CD34⁺细胞亚群的比例以及干细胞区室的克隆形成能力均保持稳定，我们对33例外周血CD34⁺细胞<19个/微升的患者调整了处理的血容量。在白细胞分离术期间监测干细胞采集情况，并将操作延长一段估计足以通过单次操作达到CD34⁺细胞目标数量的时间。根据仪器自动设置的体积计算，处理的总血容量的中位数增加了25.2%，处理的总血容量中位数为3.3倍。在所有情况下，均通过单次操作完成了足够的CD34⁺细胞采集。自体移植后，血液重建模式与所有其他患者相似。
