Billen Annelies, Madrigal J Alejandro, Szydlo Richard M, Shaw Bronwen E
UCL Cancer Institute, London, UK; Anthony Nolan, London, UK.
Transfusion. 2014 Nov;54(11):2953-60. doi: 10.1111/trf.12720. Epub 2014 May 27.
It is of clinical relevance to recognize donors who are unlikely to meet the requested stem cell dose for transplantation, as this group may benefit from an alternative mobilization regimen. This study was performed to evaluate the frequency of unrelated donor peripheral blood stem cell (PBSC) collections that meet the target yield and the impact of donor factors on this.
All sequential PBSC collections facilitated by the national registry (n = 323) from January through December 2011 were analyzed. Donor factors analyzed included age, sex, weight, and presence of a central line.
In univariate analyses, we found that reaching the target yield was significantly associated with a higher donor weight (85.6 kg vs. 75.3 kg, p < 0.001), male donor sex (55% vs. 19%, p < 0.001), a positive difference in weight between donor and recipient (4.3 kg vs. -8 kg, p < 0.001), and a higher volume of blood processed (13.8 L vs. 11.9 L, p < 0.001). After stepwise binary logistic regression, sex (p < 0.001) and difference between donor and recipient weight (p < 0.005) remained significantly associated with target yield being met after 1 day of collection.
This study shows than women and donors who are lighter than their recipient have a decreased likelihood of meeting the transplant physician's requested dose. New strategies to improve mobilization in such donors are needed. These findings may also impact future donor recruitment strategies.
识别出不太可能达到移植所需干细胞剂量的供体具有临床意义,因为这组供体可能受益于替代动员方案。本研究旨在评估达到目标产量的无关供体外周血干细胞(PBSC)采集频率以及供体因素对此的影响。
分析了2011年1月至12月由国家登记处协助进行的所有连续PBSC采集(n = 323)。分析的供体因素包括年龄、性别、体重和中心静脉置管情况。
在单因素分析中,我们发现达到目标产量与较高的供体体重(85.6千克对75.3千克,p < 0.001)、男性供体性别(55%对19%,p < 0.001)、供体与受体体重的正差值(4.3千克对 -8千克,p < 0.001)以及处理的血液量较多(13.8升对11.9升,p < 0.001)显著相关。经过逐步二元逻辑回归分析,性别(p < 0.001)和供体与受体体重差值(p < 0.005)在采集1天后仍与达到目标产量显著相关。
本研究表明,女性以及体重比受体轻的供体达到移植医生要求剂量的可能性降低。需要新的策略来改善这类供体的动员情况。这些发现也可能影响未来的供体招募策略。