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外周血干细胞的动员与采集:基于成人和儿童CD34阳性血细胞计数的血容量处理指南

Mobilization and collection of peripheral blood stem cells: guidelines for blood volume to process, based on CD34-positive blood cell count in adults and children.

作者信息

Anguita-Compagnon A T, Dibarrart M T, Palma J, Paredes L, Mosso C, Montalva R, Salas L, Araos D, Delgado I, Majlis A

机构信息

Unidad de Trasplante de Progenitores Hematopoyeticos, Clinica Alemana de Santiago, Santiago, Chile.

出版信息

Transplant Proc. 2010 Jan-Feb;42(1):339-44. doi: 10.1016/j.transproceed.2009.11.003.

Abstract

We report 189 mobilizations and 489 collections of peripheral blood stem cells (PBSC) performed in 139 autologous transplantation patients and in 28 donors for allogeneic transplantations whose ages ranged from 2-68 years. We observed a correlation (P < .001; Pearson's coefficient 0.64) between CD34-positive cells and granulocyte-macrophage colony-forming units examined to estimate PBSC. In a subset of 287 collections (97 adults and 49 children) we obtained peripheral blood (PB) CD34-positive cell counts at 2 to 4 hours before leukapheresis. We noted a correlation between PB CD34-positive cell counts before leukapheresis and the number of CD34-positive cells per kilogram of body weight collected in the whole apheresis of the day (P < .001; Pearson's coefficient 0.82). An even better correlation was obtained between PB CD34-positive cells preapheresis and the yield of each individual blood volume (BV) processed (P < .001; Pearson's coefficient 0.87). Healthy donors and patients in each age group behaved similarly. In addition, the collection yield was greater among children than adults. These findings allowed us to develop a simple predictive model to estimate the BV to process for a target dose of CD34-positive cells per kilogram, based on the level of PBSC before apheresis in children and adults.

摘要

我们报告了在139例自体移植患者和28例年龄在2至68岁之间的异基因移植供者中进行的189次外周血干细胞动员和489次外周血干细胞采集。为评估外周血干细胞,我们观察到所检测的CD34阳性细胞与粒细胞-巨噬细胞集落形成单位之间存在相关性(P < 0.001;Pearson系数为0.64)。在287次采集的一个子集中(97例成人和49例儿童),我们在白细胞分离术前2至4小时获得了外周血(PB)CD34阳性细胞计数。我们注意到白细胞分离术前PB CD34阳性细胞计数与当天整个单采过程中每千克体重采集的CD34阳性细胞数量之间存在相关性(P < 0.001;Pearson系数为0.82)。在白细胞分离术前PB CD34阳性细胞与每次处理的单个血容量(BV)的产量之间获得了更好的相关性(P < 0.001;Pearson系数为0.87)。每个年龄组的健康供者和患者表现相似。此外,儿童的采集产量高于成人。这些发现使我们能够建立一个简单的预测模型,根据儿童和成人白细胞分离术前外周血干细胞水平,估计为达到每千克目标剂量的CD34阳性细胞需要处理的血容量。

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