Itoh Tsuneo, Minegishi Masayoshi, Kudo Yoshinori, Saito Naoko, Takahashi Hiroyuki, Suzuki Akira, Narita Ayuko, Sato Yuko, Miura Junko, Inoue Yaeko, Kameoka Jun-Ichi, Suwabe Naruyoshi, Imaizumi Masue, Okuda Mitsutaka, Tsuchiya Shigeru
Division of Blood Transfusion, Tohoku University Hospital, Sendai, Japan.
J Clin Apher. 2006 Oct;21(3):176-80. doi: 10.1002/jca.20083.
We retrospectively investigated the feasibility of the apheresis procedure for red blood cell (RBC) reduction with a closed-bag system. We also sought to determine the optimal processing volume for the maximal recovery of hematopoietic progenitor cells (HPC). Twelve bone marrow (BM) harvests were processed for major ABO-incompatible allogeneic transplantation and one BM harvest was processed for autologous transplantation. The processing was performed through seven apheresis cycles with a two-bag system using COBE Spectra Version 6.1. The mean recovery rates were compared in the products after four cycles and seven cycles of BM processing. Mean cell recovery rates were 79.2% (67.6-97.5%) and 87.3% (68.9-111.9%) for the mononuclear cells (MNC) and 84.5% (69.4-109.5%) and 92.0% (79.0-107.7%) for the CD34(+) cells after four and seven cycles, respectively. A mean of 96.3% (93.0-98.1%) of the RBCs were finally removed. The yield of CD34(+) cells after seven cycles of processing (median: 10.35 x 10(7) cells) was 7.9% greater than that after four cycles of processing (median: 9.65 x 10(7) cells), exhibiting a less-than-significant enhancement in yield. The CD34(+) cell contents recovered in the concentrates up to four cycles (r = 0.989) and up to seven cycles (r = 0.993) were strongly correlated with the original content of the CD34(+) cells. Engraftment was obtained in all patients except one patient infused with purified CD34(+) cells. This latter result confirmed the hematopoietic potential of the cell populations recovered. Granulocyte recovery (defined as an absolute neutrophil cell count > or = 500/microL for a period of three consecutive days) ranged from 8 to 25 days (median: 16 days) post-transplantation. No hemolytic reaction was observed in any of the patients. Our results confirmed the efficacy of BM processing cycles with the COBE Spectra device. However, we could not conclude that the large-volume apheresis for BM processing significantly enhanced the yields of HPC. The final recovery of CD34(+) cells after processing could be predicted from the CD34(+) cell content of the original collected marrow.
我们回顾性研究了采用密闭袋系统进行红细胞(RBC)去除的单采程序的可行性。我们还试图确定能最大程度回收造血祖细胞(HPC)的最佳处理体积。对12例骨髓(BM)采集物进行处理用于主要ABO血型不相合的异基因移植,1例骨髓采集物用于自体移植。使用COBE Spectra Version 6.1双袋系统通过7个单采周期进行处理。比较了骨髓处理4个周期和7个周期后产品中的平均回收率。单核细胞(MNC)的平均细胞回收率在4个周期和7个周期后分别为79.2%(67.6 - 97.5%)和87.3%(68.9 - 111.9%),CD34(+)细胞的平均回收率在4个周期和7个周期后分别为84.5%(69.4 - 109.5%)和92.0%(79.0 - 107.7%)。最终平均去除了96.3%(93.0 - 98.1%)的红细胞。处理7个周期后CD34(+)细胞的产量(中位数:10.35×10⁷个细胞)比处理4个周期后(中位数:9.65×10⁷个细胞)高7.9%,产量提高幅度不显著。在处理至4个周期(r = 0.989)和7个周期(r = 0.993)时,浓缩物中回收的CD34(+)细胞含量与原始CD34(+)细胞含量高度相关。除1例输注纯化CD34(+)细胞的患者外,所有患者均实现了造血干细胞植入。后一结果证实了回收的细胞群体具有造血潜能。粒细胞恢复(定义为连续3天绝对中性粒细胞计数≥500/μL)发生在移植后8至25天(中位数:16天)。所有患者均未观察到溶血反应。我们的结果证实了使用COBE Spectra设备进行骨髓处理周期的有效性。然而,我们不能得出骨髓处理的大容量单采能显著提高HPC产量的结论。处理后CD34(+)细胞的最终回收率可根据原始采集骨髓中的CD34(+)细胞含量进行预测。