Delgado J, Fernandez-Jimenez M C, Martinez A, Sastre A, Garcia-Miguel P, Hernandez-Navarro F, Arrieta R
Department of Hematology, Hospital Universitario La Paz, Madrid, Spain.
Cytotherapy. 2004;6(1):43-9. doi: 10.1080/14653240310004566.
PBPC collection in children weighing </=25 kg is hampered by technical and clinical problems related to vascular access, low total blood volume, anticoagulation, side effects, and psychological impact. The aim of this study was to analyze several clinical and technical factors, other than pre-apheresis CD34(+) count, that may affect PBPC collection in these low-weight children.
Data from 88 leukaphereses performed in 45 children were analyzed, including pre-apheresis CD34(+) cell count, COBE Spectra software (version 4.7 versus 6.0), apheresis volume [standard versus large-volume leukapheresis (LVL)] and patient's diagnosis, age, weight and sex.
The median number of PBPC collected was 6.68 mononuclear cells (MNC)x10(8)/kg (range 2.36-19.05) and 1.69 CD34(+) cellsx10(6)/kg (range 0.08-13.79). Multivariate analysis showed that factors independently associated with the CD34(+) cell yield per apheresis were pre-apheresis CD34(+) cell count (P<0.001), diagnosis (P=0.008) and apheresis volume (P=0.009). Recruitment of CD34(+) cells was also independently affected by the apheresis volume, being higher in the LVL group (P=0.008).
We have demonstrated that, apart from the well-known influence of the pre-apheresis CD34(+) cell count, two other factors have a major impact on the CD34(+) cell yield: patient's diagnosis and apheresis volume. In addition, taking into account that side effects were mild and tolerable, we have confirmed that LVL is a safe and effective procedure in children </=25 kg, and that AutoPBSC software could be reliably used in these patients, provided that an experienced team performs the procedure.
体重≤25 kg儿童的外周血造血干细胞（PBPC）采集受到与血管通路、总血容量低、抗凝、副作用及心理影响相关的技术和临床问题的阻碍。本研究的目的是分析除单采前CD34(+)计数外，可能影响这些低体重儿童PBPC采集的若干临床和技术因素。
分析了45名儿童进行的88次白细胞单采的数据，包括单采前CD34(+)细胞计数、COBE Spectra软件（版本4.7与6.0）、单采量[标准与大容量白细胞单采（LVL）]以及患者的诊断、年龄、体重和性别。
采集的PBPC中位数为6.68×10⁸个单核细胞（MNC）/kg（范围2.36 - 19.05）和1.69×10⁶个CD34(+)细胞/kg（范围0.08 - 13.79）。多因素分析显示，与每次单采CD34(+)细胞产量独立相关的因素为单采前CD34(+)细胞计数（P<0.001）、诊断（P = 0.008）和单采量（P = 0.009）。CD34(+)细胞的募集也独立受单采量影响，LVL组更高（P = 0.008）。
我们已证明，除了单采前CD34(+)细胞计数的众所周知的影响外，另外两个因素对CD34(+)细胞产量有重大影响：患者的诊断和单采量。此外，考虑到副作用轻微且可耐受，我们已证实LVL在体重≤25 kg的儿童中是一种安全有效的程序，并且只要有经验的团队进行该程序，AutoPBSC软件可可靠地用于这些患者。
