Sarkodee-Adoo C, Taran I, Guo C, Buadi F, Murthy R, Cox E, Lopez R, Westphal S, Shope S, O'Connell B, Wethers L, Meisenberg B
University of Maryland School of Medicine, Greenebaum Cancer Center, Baltimore, MD, USA.
Bone Marrow Transplant. 2003 May;31(10):851-5. doi: 10.1038/sj.bmt.1704034.
We evaluated 120 leukapheresis procedures (93 patients), in order to detect clinical factors that influence the efficiency of CD34+ collection using Cobe Spectra trade mark cell separators. Hematocrit was >27% and platelet count >30 000/microl in >95% of patients. Platelet transfusions were given if the postprocedure count was &<20 000/microl. Multiple regression analysis was used to analyze putative factors, and a predictive equation defined by stepwise regression modeling. The mean efficiency was 0.59 (s.d. 0.27). Sex (M>F; P=0.01), the volume processed (inversely; P=0.01) and CD34+ cell count (inversely; P=0.04) were associated with efficiency, whereas hematocrit, platelet or leukocyte count, catheter type and patient weight were not. The effect size for predictive factors was small (R(2)=0.21). Adverse events were limited to hypocalcemia. We conclude that female sex, volume processed and CD34+ cell count adversely influence the efficiency of CD34+ cell leukapheresis. However, the impact of volume and CD34+ cell count is small, and likely to be offset by the influence of these same factors on overall yield. Leukapheresis appears to be safe and efficient for autologous blood and marrow transplantation patients with hematocrit >27% and platelet count >30 000/microl.
我们评估了120例白细胞单采程序（涉及93名患者），以检测影响使用Cobe Spectra商标细胞分离器采集CD34+细胞效率的临床因素。超过95%的患者血细胞比容>27%且血小板计数>30000/微升。如果术后计数<20000/微升，则给予血小板输注。采用多元回归分析来分析假定因素，并通过逐步回归建模定义预测方程。平均效率为0.59（标准差0.27）。性别（男性>女性；P=0.01）、处理的体积（呈负相关；P=0.01）和CD34+细胞计数（呈负相关；P=0.04）与效率相关，而血细胞比容、血小板或白细胞计数、导管类型和患者体重则无关。预测因素的效应量较小（R²=0.21）。不良事件仅限于低钙血症。我们得出结论，女性性别、处理的体积和CD34+细胞计数对CD34+细胞白细胞单采的效率有不利影响。然而，体积和CD34+细胞计数的影响较小，并且可能会被这些相同因素对总产量的影响所抵消。对于血细胞比容>27%且血小板计数>30000/微升的自体血液和骨髓移植患者，白细胞单采似乎是安全有效的。
