Ings Stuart J, Balsa Carmen, Leverett David, Mackinnon Stephen, Linch David C, Watts Michael J
Royal Free and University College London Medical School, London, UK.
Br J Haematol. 2006 Sep;134(5):517-25. doi: 10.1111/j.1365-2141.2006.06223.x.
Mobilised peripheral blood is now the main source of stem cells collected from normal donors. We report our experience of mobilising and collecting 400 normal healthy donors using standardised procedures and techniques. Target recipient doses were reached with one aphaeresis in 63% of donors and with two aphereses in 81% of donors. Approximately 2% of donors yielded such low progenitor values that they were termed 'poor mobilisers'. There were minor effects of donor age, weight and sex and where possible, larger male donors under the age of 55 years should be selected. Two forms of granulocyte colony-stimulating factor (G-CSF) were used at the same dose and no significant difference was seen in the yield of CD34+ cells collected/l of blood processed. However, a greater number of granulocyte-macrophage colony-forming cells were harvested using lenograstim (glycosylated G-CSF) compared with filgrastim (non-glycosylated G-CSF; P = 0.002). CD34+ cell yields were also measured halfway through the aphaeresis procedure. This was found to be highly predictive of final yield and facilitated distribution of the stem cell product to other centres. The observation that CD34+ yields did not decline in the second half compared with the first half of aphaeresis suggests that the circulating cell numbers are not static.
动员后的外周血现在是从正常供体采集干细胞的主要来源。我们报告了我们使用标准化程序和技术动员和采集400名正常健康供体的经验。63%的供体通过一次单采达到目标受者剂量,81%的供体通过两次单采达到目标受者剂量。约2%的供体产生的祖细胞值很低,被称为“低动员者”。供体年龄、体重和性别有轻微影响,可能的话,应选择55岁以下体型较大的男性供体。两种粒细胞集落刺激因子(G-CSF)使用相同剂量,每升处理血液中采集的CD34+细胞产量未见显著差异。然而,与非格司亭(非糖基化G-CSF)相比,使用来格司亭(糖基化G-CSF)收获的粒细胞-巨噬细胞集落形成细胞数量更多(P = 0.002)。在单采过程中途也测量了CD34+细胞产量。发现这对最终产量具有高度预测性,并有助于将干细胞产品分配到其他中心。与单采前半段相比,后半段CD34+产量没有下降,这一观察结果表明循环细胞数量并非静止不变。