Lazarus H M, Pecora A L, Shea T C, Koç O N, White J M, Gabriel D A, Cooper B W, Gerson S L, Krieger M, Sing A P
Department of Medicine, Ireland Cancer Center of Case Western Reserve University, University Hospitals of Cleveland, Cleveland, OH 44106, USA.
Bone Marrow Transplant. 2000 Mar;25(5):559-66. doi: 10.1038/sj.bmt.1702175.
The purpose of this study was to investigate whether storing mobilized peripheral blood progenitor cell (PBPC) collections overnight before CD34+ selection may delay platelet count recovery after high-dose chemotherapy and CD34+-enriched PBPC re-infusion. Lymphoma patients underwent PBPC mobilization with cyclophosphamide 4 g/m2 i.v. and G-CSF 10 microg/kg/day subcutaneously. Patients were prospectively randomized to have each PBPC collection enriched for CD34+ cells with the CellPro CEPRATE SC System either immediately or after overnight storage at 4 degrees C. Thirty-four patients were randomized to overnight storage and 34 to immediate processing of PBPC; 15 were excluded from analysis due to tumor progression or inadequate CD34+ cell mobilization. PBPC from 23 patients were stored overnight, while 30 subjects underwent immediate CD34+ selection and cryopreservation. Median yield of CD34+ enrichment was 43.6% in the immediate processing group compared to 39.1% in the overnight storage group (P = 0.339). Neutrophil recovery >500 x 10(9)/l occurred a median of 11 days (range 9-16 days) in the overnight storage group compared to 10.5 days (range 9-21 days) in the immediate processing group (P = 0.421). Median day to platelet transfusion independence was 13 (range 7-43) days in the overnight storage group vs 13.5 (range 8-35) days in those assigned to immediate processing (P = 0.933). We conclude that storage of PBPC overnight at 4 degrees C allows pooling of consecutive-day collections resulting in decreased costs and processing time without compromising neutrophil and platelet engraftment after infusion of CD34+-selected progenitor cells. Bone Marrow Transplantation(2000) 25, 559-566.
本研究的目的是调查在进行CD34+选择前将动员的外周血祖细胞(PBPC)采集物过夜储存是否会延迟大剂量化疗和CD34+富集的PBPC再输注后血小板计数的恢复。淋巴瘤患者接受环磷酰胺4 g/m2静脉注射和粒细胞集落刺激因子10 μg/kg/天皮下注射进行PBPC动员。患者被前瞻性随机分为两组,一组使用CellPro CEPRATE SC系统立即对每次PBPC采集物进行CD34+细胞富集,另一组在4℃过夜储存后进行富集。34例患者被随机分配至过夜储存组,34例被随机分配至PBPC立即处理组;15例因肿瘤进展或CD34+细胞动员不足被排除在分析之外。23例患者的PBPC被过夜储存,而30例受试者立即进行CD34+选择和冷冻保存。立即处理组CD34+富集的中位产量为43.6%,过夜储存组为39.1%(P = 0.339)。过夜储存组中性粒细胞恢复>500×10(9)/l的中位时间为11天(范围9 - 16天),立即处理组为10.5天(范围9 - 21天)(P = 0.421)。过夜储存组血小板输注独立的中位天数为13天(范围7 - 43天),立即处理组为13.5天(范围8 - 35天)(P = 0.933)。我们得出结论,PBPC在4℃过夜储存可使连续几天的采集物合并,从而降低成本和处理时间,且不影响输注CD34+选择的祖细胞后中性粒细胞和血小板的植入。《骨髓移植》(2000年)25卷,559 - 566页 。