Azzouqa Abdel-Ghani M, Jouni Kinda, Roy Vivek, Zubair Abba C
Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida.
Division of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida.
J Clin Apher. 2019 Feb;34(1):39-43. doi: 10.1002/jca.21672. Epub 2018 Nov 14.
Mobilization regimen choice is a significant contributing factor for successful hematopoietic progenitor cell (HPC) collection by leukocytapheresis and reaching the target CD34+ cell dose. How mobilization regimen affects collection efficiency and the quality of products collected using the Spectra Optia apheresis instrument is not fully known.
We evaluated the impact of granulocyte-colony stimulating factor (GCSF) and GCSF/plerixafor mobilization regimens on CE and product composition. We studied 373 leukocytapheresis HPC collections for 147 autologous transplants from January 1, 2010 to December 31, 2014. Patients were categorized in two groups; good mobilizers, mobilized with GCSF only (GM) and poor mobilizers, mobilized with GCSF and Plerixafor (PM).
Overall, compared with PM group, total nucleated cell (TNC) yield was significantly lower in GM group (P = <.001). In contrast, median percent mononuclear cell (MNC) collected from GM (86.5%) was significantly higher than products collected from PM group (79.5%; P < .001). Compared with GM group, CD34+ cell CE was about 10% lower in PM group (P < .008). In addition, daily CD34+ cell/Kg yield was significantly higher in GM (2.08 × 10/Kg) compared with PM group (1.64 x 10/Kg, P = .019). Overall, the median number of collections per patient was two for GM and three for PM (P = .004).
Products collected from PM group contained higher TNC content relative to GM group but had lower MNC enrichment, CD34+ cell CE and daily CD34+ cell yield per Kg.
动员方案的选择是通过白细胞单采术成功采集造血祖细胞（HPC）并达到目标CD34+细胞剂量的一个重要因素。目前尚不完全清楚动员方案如何影响采集效率以及使用Spectra Optia血细胞分离仪采集的产品质量。
我们评估了粒细胞集落刺激因子（GCSF）和GCSF/普乐沙福动员方案对采集效率（CE）和产品成分的影响。我们研究了2010年1月1日至2014年12月31日期间147例自体移植的373次白细胞单采术HPC采集。患者分为两组；动员效果好的患者，仅用GCSF动员（GM），动员效果差的患者，用GCSF和普乐沙福动员（PM）。
总体而言，与PM组相比，GM组的总核细胞（TNC）产量显著更低（P = <.001）。相反，GM组采集的单核细胞（MNC）中位数百分比（86.5%）显著高于PM组采集的产品（79.5%；P <.001）。与GM组相比，PM组的CD34+细胞采集效率低约10%（P <.008）。此外，GM组的每日CD34+细胞/千克产量（2.08×10/千克）显著高于PM组（1.64×10/千克，P =.019）。总体而言，GM组每位患者的采集中位数次数为2次，PM组为3次（P =.004）。
与GM组相比，PM组采集的产品TNC含量更高，但MNC富集度、CD34+细胞采集效率和每千克每日CD34+细胞产量更低。
