Department of Pathology and Genomic Medicine, Cell and Gene Therapy Department, Baylor College of Medicine, Houston, Texas; The Methodist Hospital, Houston, Texas; Gulf Coast Regional Blood Center, Houston, Texas.
Transfusion. 2014 Jan;54(1):203-10. doi: 10.1111/trf.12238. Epub 2013 Jun 13.
The use of hematopoietic progenitor cell (HPC) transplantation has rapidly expanded in recent years. Currently, several sources of HPCs are available for transplantation including peripheral blood HPCs (PBPCs), cord blood cells, and marrow cells. Of these, PBPC collection has become the major source of HPCs. An important variable in PBPC collection is the response to PBPC mobilization, which varies significantly and sometime causes mobilization failure.
A retrospective study of 69 healthy donors who underwent PBPC donation by leukapheresis was performed. All of these donors received 10 μg/kg/day or more granulocyte-colony-stimulating factor (G-CSF) for 5 days before PBPC harvest. Donor factors were evaluated and correlated with mobilization responses, as indicated by the precollection CD34 count (pre-CD34).
Donors with a pre-CD34 of more than 100 × 10(6) /L had higher body mass index (BMI) compared with donors whose pre-CD34 was 38 × 10(6) to 99 × 10(6) /L or less than 38 × 10(6) /L (32.0 ± 1.04 kg/m(2) vs. 28.7 ± 0.93 kg/m(2) vs. 25.9 ± 1.27 kg/m(2) , respectively; p < 0.05). In addition, donors with high BMIs had higher pre-CD34 on a per-kilogram-of-body-weight basis compared with donors with low BMIs.
BMI is an important factor that affects donor's response to mobilization and consequently the HPC yield. This effect may be due to a relatively high dose of G-CSF administered to donors with higher BMI or due to the presence of unknown intrinsic factors affecting mobilization that correlate with the amount of adipose tissue in each donor.
近年来，造血祖细胞（HPC）移植的应用迅速扩大。目前，有几种 HPC 来源可用于移植，包括外周血 HPC（PBPC）、脐带血细胞和骨髓细胞。其中，PBPC 采集已成为 HPC 的主要来源。PBPC 采集的一个重要变量是对 PBPC 动员的反应，这种反应差异很大，有时会导致动员失败。
对 69 名接受 PBPC 采集的健康供者进行了回顾性研究。所有供者在 PBPC 采集前 5 天接受 10μg/kg/天或更高剂量的粒细胞集落刺激因子（G-CSF）治疗。评估了供者因素，并与采集前 CD34 计数（pre-CD34）所示的动员反应相关。
pre-CD34 大于 100×10(6)/L 的供者体重指数（BMI）高于 pre-CD34 为 38×10(6)至 99×10(6)/L 或小于 38×10(6)/L 的供者（32.0±1.04kg/m(2)比 28.7±0.93kg/m(2)比 25.9±1.27kg/m(2)；p<0.05）。此外，BMI 较高的供者每公斤体重的 pre-CD34 也较高。
BMI 是影响供者动员反应进而影响 HPC 产量的重要因素。这种影响可能是由于给予 BMI 较高的供者较高剂量的 G-CSF，也可能是由于存在与每个供者脂肪组织量相关的未知内在动员因素。
