Pierelli L, Maresca M, Piccirillo N, Pupella S, Gozzer M, Foddai M L, Vacca M, Adorno G, Coppetelli U, Paladini U
Immunohematology and Transfusion Medicine, ASL Viterbo, Viterbo, Italiy.
Vox Sang. 2006 Aug;91(2):126-34. doi: 10.1111/j.1423-0410.2006.00796.x.
Stem cell collection is a standard procedure for the procurement of autologous grafts to rescue myelosuppression induced by high-dose treatments. Accurate prediction of collection yields may contribute to optimize planning and quality control of collection.
Data of 313 autologous haematopoietic stem cell (AHSC) evaluable collections performed in 208 patients with haematologic and non-haematologic neoplasms from seven centres were prospectively analysed to test the accuracy of yield predictions generated by a formula that required the input of peripheral blood (PB) CD34+ cell precount and desired PB volume to be processed. Data were matched in a standard linear regression, in a zero-point regression analysis and tested for prediction accuracy. Further 165 AHSC collections were analysed on a single-centre basis, using yield predictions as reference standards.
Analysis showed high levels of correlation between measured collection yields (my) and predictions (py) (R = 0.85; P = 0.000000) as well as high degree of prediction accuracy (my vs. py at paired t-test: P = 0.114781; median my/py ratio = 1.23). Analysis of additional 165 AHSC collections on a single-centre basis showed that the analysed centres had 70% or more measured yields comprising the 0.6-1.8 interval of the my/py ratio. The observance of the 'efficiency' my/py interval assured collection quality control in these centres confirming the reliability of the method.
This prediction method generates accurate and immediate yield predictions allowing collection planning and rapid efficiency control. As a consequence of our study, four centres out of seven use the described method to plan both leukapheresis number and single-procedure blood processing volume while the remaining three centres plan leukapheresis number on the basis of our predictions, maintaining a fixed single-procedure 200 ml/kg blood volume processing, according to their centre AHSC collection policy.
干细胞采集是获取自体移植物以挽救大剂量治疗所致骨髓抑制的标准程序。准确预测采集产量有助于优化采集计划和质量控制。
前瞻性分析了来自七个中心的208例血液系统和非血液系统肿瘤患者进行的313次可评估的自体造血干细胞(AHSC)采集数据,以检验一个公式所生成的产量预测的准确性,该公式需要输入外周血(PB)CD34+细胞预计数和待处理的目标PB体积。数据在标准线性回归、零点回归分析中进行匹配,并测试预测准确性。另外165次AHSC采集在单中心基础上进行分析,将产量预测作为参考标准。
分析显示测量的采集产量(my)与预测值(py)之间具有高度相关性(R = 0.85;P = 0.000000),以及高度的预测准确性(配对t检验时my与py比较:P = 0.114781;my/py比值中位数 = 1.23)。在单中心基础上对另外165次AHSC采集的分析表明,所分析的中心有70%或更多的测量产量包含在my/py比值的0.6 - 1.8区间内。遵守“效率”my/py区间确保了这些中心的采集质量控制,证实了该方法的可靠性。
这种预测方法能生成准确且即时的产量预测,有助于采集计划制定和快速效率控制。作为我们研究的结果,七个中心中有四个使用所描述的方法来规划白细胞单采次数和单次采血处理量,而其余三个中心根据我们的预测来规划白细胞单采次数,按照其中心的AHSC采集政策保持固定的单次200 ml/kg血量处理。