用于移植的ABO血型不匹配骨髓处理：114例手术结果及即时不良事件和造血恢复分析

ABO-mismatched marrow processing for transplantation: results of 114 procedures and analysis of immediate adverse events and hematopoietic recovery.

作者信息

Larghero Jerome, Rea Delphine, Esperou Helene, Biscay Nicole, Maurer Marie-Noelle, Lacassagne Marie-Noelle, Ternaux Brigitte, Traineau Richard, Yakouben Karima, Dosquet Christine, Socié Gerard, Gluckman Eliane, Benbunan Marc, Marolleau Jean-Pierre

机构信息

Cell Therapy Unit and Bone Marrow Transplant Department, Saint-Louis Hospital, Paris, France.

出版信息

Transfusion. 2006 Mar;46(3):398-402. doi: 10.1111/j.1537-2995.2006.00735.x.

DOI:10.1111/j.1537-2995.2006.00735.x

PMID:16533282

Abstract

BACKGROUND

Red cell (RBC) depletion is needed to bypass ABO mismatch in allogeneic bone marrow transplantation (BMT). Technical and clinical data obtained after bone marrow (BM) processing with a continuous-flow cell separator (Cobe Spectra, Gambro BCT) are reported.

STUDY DESIGN AND METHODS

RBC depletion and recovery of nucleated cells, CD3+ cells, CD34+ cells, and colony-forming unit-granulocyte-macrophage were calculated. Bacteriologic contaminations, side effects of graft infusion, and hematopoietic recovery were analyzed.

RESULTS

A total of 114 BM samples were processed. The mean volume collected was 1099 mL (range, 390-2450 mL). Initial and residual mean RBCs volumes were 309.9 and 4.0 mL corresponding to a depletion of 98.6 +/- 0.78 percent. Before processing, the mean numbers of nucleated cells, granulocytes, CD3+ cells, CD34+ cells, and CFU-GM were 20.28 x 10(9), 12.79 x 10(9), 1.96 x 10(9), 356.7 x 10(6), and 195.6 x 10(5), respectively. The mean corresponding recoveries after processing were 33.66, 48.98, 82.02, 82.2, and 93.9 percent. Limited side effects were observed in 14 patients without correlation with residual RBCs volume. All but two patients engrafted.

CONCLUSION

BM processing with the Cobe Spectra cell separator provides high rates of RBC depletion without significant side effects after BMT.

摘要

背景

在异基因骨髓移植（BMT）中，需要去除红细胞（RBC）以绕过ABO血型不匹配。本文报告了使用连续流动细胞分离器（Cobe Spectra，Gambro BCT）处理骨髓（BM）后获得的技术和临床数据。

研究设计与方法

计算红细胞去除率以及有核细胞、CD3 +细胞、CD34 +细胞和集落形成单位 - 粒细胞 - 巨噬细胞的回收率。分析细菌污染、移植物输注的副作用和造血恢复情况。

结果

共处理了114份骨髓样本。收集的平均体积为1099 mL（范围为390 - 2450 mL）。初始和残余平均红细胞体积分别为309.9 mL和4.0 mL，去除率为98.6±0.78%。处理前，有核细胞、粒细胞、CD3 +细胞、CD34 +细胞和CFU - GM的平均数量分别为20.28×10⁹、12.79×10⁹、1.96×10⁹、356.7×10⁶和195.6×10⁵。处理后的平均相应回收率分别为33.66%、48.98%、82.02%、82.2%和93.9%。14例患者观察到有限的副作用，且与残余红细胞体积无关。除两名患者外，所有患者均植入成功。