Schwarer A P, Messino N M, Gibson M, Akers C, Taouk Y
Bone Marrow Transplant Programme, Alfred Hospital, Melbourne, Australia.
J Hematother Stem Cell Res. 2000 Apr;9(2):269-74. doi: 10.1089/152581600319496.
High-dose chemotherapy followed by autologous PBSC transplantation (PBSCT) has become an accepted form of therapy for a number of malignant hematologic diseases. The optimal method for the collection of PBSC is yet to be defined. Large-volume leukapheresis may be able to collect adequate numbers of PBSC with the patient undergoing fewer procedures. We routinely process 7 L of blood per leukapheresis. Hence, we elected to assess whether a modest increase in the blood volume processed would, on average, decrease the number of leukaphereses each patient needed to undergo to collect > or =2 x 10(6) CD34+ cells/kg body weight. Sixty patients were randomized to undergo 7 L leukaphereses (n = 31 patients; 87 leukaphereses) or 10 L leukaphereses (n = 29 patients; 81 leukaphereses). The median number of leukaphereses required per patient to collect the target number of CD34+ cells was two (range one to five) for both groups (p = 0.83). The median number of nucleated cells collected per patient was greater for the 10 L group (8.2 x 10(8)/kg versus 5.3 x 10(8)/kg, p = 0.005), as was the median number of mononuclear cells (MNC) (4.7 x 10(8)/kg versus 3.6 x 10(8)/kg, p = 0.0001), whereas there was no statistical difference between the groups for the median number of CD34+ cells collected per patient (3.2 x 10(6)/kg versus 3.7 x 10(6)/kg, p = 0.98). Therefore, over the 18-month period of this trial, the use of a 10 L leukapheresis volume did not decrease the number of leukaphereses performed compared with a 7 L leukapheresis volume.
大剂量化疗后进行自体外周血干细胞移植（PBSCT）已成为多种恶性血液病公认的治疗方式。采集外周血干细胞的最佳方法尚未明确。大容量白细胞单采术或许能够采集到足够数量的外周血干细胞，且患者所需的操作次数更少。我们每次白细胞单采术常规处理7升血液。因此，我们决定评估适度增加处理的血量是否平均而言会减少每位患者为采集≥2×10⁶个CD34⁺细胞/千克体重所需进行的白细胞单采术次数。60例患者被随机分为接受7升白细胞单采术组（n = 31例患者；87次白细胞单采术）或10升白细胞单采术组（n = 29例患者；81次白细胞单采术）。两组患者采集目标数量的CD34⁺细胞所需的白细胞单采术次数中位数均为2次（范围1至5次）（p = 0.83）。10升组每位患者采集的有核细胞中位数更多（8.2×10⁸/千克对5.3×10⁸/千克，p = 0.005），单个核细胞（MNC）中位数也是如此（4.7×10⁸/千克对3.6×10⁸/千克，p = 0.0001），而两组患者每位患者采集的CD34⁺细胞中位数无统计学差异（3.2×10⁶/千克对3.7×10⁶/千克，p = 0.98）。因此，在该试验的18个月期间，与7升白细胞单采量相比，使用10升白细胞单采量并未减少白细胞单采术的执行次数。
