Szymanski James, Troendle James, Leitman Susan, Hong Hong, Yau Yu Ying, Cantilena Cathy
Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland.
Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Transfusion. 2019 Jan;59(1):259-266. doi: 10.1111/trf.15000. Epub 2018 Nov 16.
Short- and long-term effects of mobilization regimens in hematopoietic stem cell and granulocyte donors have been well characterized. In this study, we examined the longitudinal hematopoietic changes related to repeat stimulated granulocyte donation.
Complete blood counts for consecutive granulocyte donors between October 1994 and May 2017 were compared to unstimulated granulocyte donors. Plateletpheresis donors served as controls. The longitudinal change in precollection white blood cell (WBC) counts for these donor groups were modeled using a linear mixed-effects model. The investigated variables were granulocyte, lymphocyte, and monocyte counts and the granulocyte collection yield. Contrasts were performed to explore the effect of donation number on precollection counts.
For the granulocyte-colony-stimulating factor plus dexamethasone (G-CSF/Dex)-stimulated group, both the granulocyte and the lymphocyte counts decreased 6.51 × 10 /L (-23.1%, p < 0.001) and 0.21 × 10 /L (-20.4%, p < 0.001), respectively, between Donation 1 and Donation 20. This effect was still present at the 3- to 4-year interval (b = -0.0008313, SE = 0.00029, p = 0.004). For the unstimulated donor group between Donation 1 and Donation 20, the lymphocyte count decreased by 0.62 × 10 /L (-51.5%, p < 0.001). This effect was only significant up to Year 2 (b = -0.0026, SE = 0.0010, p = 0.013).
Past granulocyte donations were found to have a statistically strong negative effect on precollection granulocyte counts and lymphocyte counts and decreased granulocyte yield both in the G-CSF/Dex-stimulated donors and the unstimulated donors. In this statistical model, for both these groups, the effect of past donations on granulocyte and WBC counts were still detectable 2 years later.
造血干细胞和粒细胞供体动员方案的短期和长期影响已得到充分表征。在本研究中,我们研究了与重复刺激粒细胞捐献相关的纵向造血变化。
将1994年10月至2017年5月期间连续的粒细胞供体的全血细胞计数与未刺激的粒细胞供体进行比较。血小板单采供体作为对照。使用线性混合效应模型对这些供体组采集前白细胞(WBC)计数的纵向变化进行建模。研究的变量包括粒细胞、淋巴细胞和单核细胞计数以及粒细胞采集产量。进行对比以探讨捐献次数对采集前计数的影响。
对于粒细胞集落刺激因子加地塞米松(G-CSF/Dex)刺激组,在第1次捐献和第20次捐献之间,粒细胞计数和淋巴细胞计数分别下降了6.51×10⁹/L(-23.1%,p<0.001)和0.21×10⁹/L(-20.4%,p<0.001)。在3至4年的间隔期这种影响仍然存在(b=-0.0008313,标准误=0.00029,p=0.004)。对于未刺激供体组,在第1次捐献和第20次捐献之间,淋巴细胞计数下降了0.62×10⁹/L(-51.5%,p<0.001)。这种影响仅在第2年之前显著(b=-0.0026,标准误=0.0010,p=0.013)。
发现既往粒细胞捐献对采集前粒细胞计数和淋巴细胞计数有统计学上显著的负面影响,并且在G-CSF/Dex刺激的供体和未刺激的供体中均降低了粒细胞产量。在该统计模型中,对于这两组,既往捐献对粒细胞和白细胞计数的影响在2年后仍然可检测到。