Moog R, Basu O, Kremens B
Institute for Transfusion Medicine, University Clinics Essen, Essen, Germany.
J Clin Apher. 2003;18(3):111-4. doi: 10.1002/jca.10050.
When harvesting peripheral progenitor cells (PPC) in children, the special situation of their circulatory system has to be taken into account. Therefore, extracorporeal blood volume and product volume should be small to avoid side effects. Nine children (age 2-14 years, weight 12.8-58.5 kg) with malignancies underwent 10 PPC collections with the MNC programme of the Amicus blood cell separator. The disposable kit was primed with red blood cells (RBCs) or human albumin to avoid circulatory side effects. The children were monitored for blood pressure and heart rate during the whole apheresis procedure. A median blood volume of 4,577 ml (range 3,536-8,596 ml) was processed in a separation time of 270 min (range 176-331 min). The median product weight was 81 g (range 53-107 g) and the yield of CD 34 antigen expressing cells was 12.5 x 10(6)/kg body weight (range 1.8-26 x 10(6)/kg body weight). Only one child had to undergo a second apheresis to collect the desired transplantation dose. The median platelet contamination of the product was 0.32 x 10(11) (0.13-0.85 x 10(11)). No circulatory side effects were observed. Blood flow alarms occurred in seven of ten aphereses and one collection had to be terminated due to insufficient flow. PPC can be efficiently collected in children with the MNC programme without circulatory side effects. The platelet contamination of the product was low due to the elutriation principle of the collection process, thereby avoiding thrombocytopenic bleeding episodes in the patients.
在采集儿童外周血祖细胞（PPC）时，必须考虑其循环系统的特殊情况。因此，体外血容量和产品体积应较小，以避免副作用。9名患有恶性肿瘤的儿童（年龄2 - 14岁，体重12.8 - 58.5千克）使用Amicus血细胞分离机的单核细胞（MNC）程序进行了10次PPC采集。一次性试剂盒用红细胞（RBC）或人白蛋白预充，以避免循环系统副作用。在整个单采过程中对儿童的血压和心率进行监测。在270分钟（范围176 - 331分钟）的分离时间内处理的中位血容量为4577毫升（范围3536 - 8596毫升）。中位产品重量为81克（范围53 - 107克），表达CD 34抗原细胞的产量为12.5×10⁶/千克体重（范围1.8 - 26×10⁶/千克体重）。只有一名儿童需要进行第二次单采以采集所需的移植剂量。产品的中位血小板污染为0.32×10¹¹（0.13 - 0.85×10¹¹）。未观察到循环系统副作用。十次单采中有七次出现血流警报，一次采集因血流不足而终止。使用MNC程序可在儿童中有效采集PPC，且无循环系统副作用。由于采集过程的淘洗原理，产品的血小板污染较低，从而避免了患者出现血小板减少性出血事件。
