Zubair Abba C, Grant Rhonda, Wu Wenting, Tun Han, Rivera Candido, Moreno-Aspitia Alvaro, Joyce Michael, Roy Vivek, Colon-Otero Gerardo, Solberg Lawrence A
Transfusion Medicine, Department of Pathology and Division of Hematology/Oncology, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA.
Transfusion. 2008 Jun;48(6):1106-14. doi: 10.1111/j.1537-2995.2008.01651.x. Epub 2008 Feb 25.
It is often a clinical dilemma to determine when to collect autologous peripheral blood progenitor cells (PBPCs) in patients who received prior chemotherapy. It is also challenging to predict if the collected cells will be enough for one or two transplants.
A total of 103 PBPC donors were followed to evaluate factors that predict poor autologous PBPC collection. The donors were categorized into three groups: plasma cell disorders (PCDs), lymphomas, and normal allogeneic donors.
Our evaluation showed that platelet (PLT) count before growth factor administration significantly correlated with total CD34+ cell yield (Spearman r = 0.38, p < 0.001). Further analysis showed this correlation was only significant in plasma cell disease patients who received prior chemotherapy (Spearman r = 0.5, p = 0.008). Baseline PLT counts did not correlate with PBPC collection yield in untreated PCD, lymphoma, and normal allogeneic donors. In addition, daily PLT count during PBPC harvest correlated with CD34+ cell yield for that day (Spearman r = 0.41, p < 0.001). With a multiple linear regression model (adjusted R(2) = 0.31, AIC = 63.1), it has been determined that the baseline PLT count significantly correlates with total CD34+ cell yield in treated PCD patients.
Baseline PLT count is a sensitive indicator of autologous PBPC mobilization in PCD patients who received prior chemotherapy. This finding may be considered before growth factor administration to determine the optimal period to mobilize treated PCD patients and to predict if enough cells can be collected for one or two transplants.
对于接受过先前化疗的患者,确定何时采集自体外周血祖细胞(PBPCs)常常是一个临床难题。预测采集的细胞是否足以进行一次或两次移植也具有挑战性。
共对103名PBPC供者进行随访,以评估预测自体PBPC采集不佳的因素。将供者分为三组:浆细胞疾病(PCDs)、淋巴瘤和正常异基因供者。
我们的评估显示,生长因子给药前的血小板(PLT)计数与总CD34+细胞产量显著相关(Spearman相关系数r = 0.38,p < 0.001)。进一步分析表明,这种相关性仅在接受过先前化疗的浆细胞疾病患者中显著(Spearman相关系数r = 0.5,p = 0.008)。基线PLT计数与未治疗的PCD、淋巴瘤和正常异基因供者的PBPC采集产量无关。此外,PBPC采集期间的每日PLT计数与当天的CD34+细胞产量相关(Spearman相关系数r = 0.41,p < 0.001)。通过多元线性回归模型(调整后R(2) = 0.31,AIC = 63.1),已确定基线PLT计数与接受治疗的PCD患者的总CD34+细胞产量显著相关。
基线PLT计数是接受过先前化疗的PCD患者自体PBPC动员的敏感指标。在给予生长因子之前可考虑这一发现,以确定动员接受治疗的PCD患者的最佳时期,并预测是否能够采集到足够的细胞进行一次或两次移植。