Division of Pediatric Hematology/Oncology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Hematology, University Hospital/Inselspital Bern and University of Bern, Bern, Switzerland.
Bone Marrow Transplant. 2019 Jun;54(6):885-893. doi: 10.1038/s41409-018-0353-8. Epub 2018 Oct 23.
Collection of peripheral blood progenitor cells by leukapheresis is the preferred method to obtain grafts for autologous transplantation. Optimizing this procedure is important to warrant sufficient cell yield and reduce associated risks. To obtain sufficient to optimal yields of ≥ 2 to ≥ 5 × 10 CD34+ cells/kg body weight with a single leukapheresis procedure, success rates between 83 and 92% have been reported in children. In this retrospective study, we describe an improved protocol for autologous stem cell collection with an extraordinarily high success rate applied in 122 consecutive pediatric patients treated at the University Hospital Bern between 2004 and 2017. By comparing our data with previous studies, we identify two main optimizing factors: higher pre-apheresis CD34+ cell counts with a median of 130/µl and higher blood flow rates of 42-100 ml/min. Consequently, blood volumes processed were increased, duration of leukapheresis was shorter and CD34+ cell yields with a median of 19.0 × 10/kg body weight were higher than previously described. Safety in our study was comparable to previous studies. Based on our data, we present an innovative algorithm for determination of the necessary blood volume and time of pediatric leukapheresis procedure.
通过白细胞分离术采集外周血祖细胞是获得自体移植移植物的首选方法。优化此过程对于保证足够的细胞产量并降低相关风险非常重要。为了通过单次白细胞分离术获得足够（≥2 至≥5×10 CD34+细胞/kg 体重）至最佳产量，在儿童中已有报道称，成功率在 83%至 92%之间。在这项回顾性研究中，我们描述了一种改良的自体干细胞采集方案，该方案在 2004 年至 2017 年期间在伯尔尼大学医院接受治疗的 122 例连续儿科患者中应用，成功率极高。通过将我们的数据与以前的研究进行比较，我们确定了两个主要的优化因素：较高的预处理 CD34+细胞计数（中位数为 130/µl）和较高的血流速度（42-100ml/min）。因此，处理的血量增加，白细胞分离术的持续时间缩短，CD34+细胞产量（中位数为 19.0×10/kg 体重）高于以前的描述。本研究中的安全性与以前的研究相似。基于我们的数据，我们提出了一种用于确定儿科白细胞分离术所需血量和时间的创新算法。
