Pascual Cristina, González-Arias Elena, Pérez-Corral Ana María, Bailén Rebeca, Gayoso Jorge, Besson Nelly, Serrano David, Kwon Mi, Anguita Javier, Díez-Martín José Luis
Hemathology and Hemotherapy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
J Clin Apher. 2019 Aug;34(4):359-366. doi: 10.1002/jca.21679. Epub 2018 Dec 14.
Extracorporeal photopheresis (ECP) is an efficient and established therapy to treat acute and chronic graft vs host disease (GVHD). Using an "off-line" method, the first step (mononuclear cell [MNC] collection) is decisive, as long as a high MNC yield and purity in the collected product is desirable. Two "off-line" devices were compared: the COBE Spectra and the Spectra Optia (Terumo BCT), using both continuous and intermittent protocols.
Twelve patients with GvHD (7 acute/5 chronic) were enrolled between June 2014 and May 2015 and were alternatively assigned for each procedure to either the COBE Spectra or the Spectra Optia cell separator. Patients characteristics and procedure/product parameters were analyzed.
Two hundred procedures (100 per device) were included. The Spectra Optia system showed higher total nucleated cells and MNC collection efficiencies (18.6(10.2-29.7) vs 7.9(4.1-14.8)% and 43.6(20.3-59.5) vs 23.3(11.4-37.1)%, P < .001) and monocyte and lymphocyte collection efficiencies (55.2(17.7-83.2) vs 22.8(9-38.9)% and 38.3(26.7-53.4) vs 22.2(9-38.9)%, respectively, P < .001). Absolute platelet loss (PL) and PL per liter of blood processed were significantly lower in the Spectra Optia group (22.9(18.3-28.1) vs 33.6(26.5-41.1)%, P < .001 and 3.7(3.1-4.5) vs 4.3(3.5-4.2)%, P = .01, respectively). However, granulocyte contamination was higher (4.5(1.3-36) vs 1.2(0.4-5.7)%, P < .001) and a higher product haematocrit was obtained with the Spectra Optia (1(0.5-1.6) vs 0.3(0.2-0.5)%, P < .001), without an impact on irradiation time.
In our study, Spectra Optia proved to be safe and effective in collecting MNC with high yield and purity for ECP in GvHD.
体外光化学疗法（ECP）是治疗急慢性移植物抗宿主病（GVHD）的一种有效且成熟的疗法。采用“离线”方法时，第一步（单核细胞[MNC]采集）至关重要，因为所采集产品中需要高MNC产量和纯度。比较了两种“离线”设备：COBE Spectra和Spectra Optia（Terumo BCT），采用连续和间歇方案。
2014年6月至2015年5月期间招募了12例GVHD患者（7例急性/5例慢性），并将他们交替分配到COBE Spectra或Spectra Optia细胞分离器进行每种操作。分析了患者特征和操作/产品参数。
共纳入200次操作（每个设备100次）。Spectra Optia系统显示出更高的总核细胞和MNC采集效率（分别为18.6(10.2 - 29.7)% 对7.9(4.1 - 14.8)%以及43.6(20.3 - 59.5)% 对23.3(11.4 - 37.1)%，P <.001），单核细胞和淋巴细胞采集效率也更高（分别为55.2(17.7 - 83.2)% 对22.8(9 - 38.9)%以及38.3(26.7 - 53.4)% 对22.2(9 - 38.9)%，P <.001）。Spectra Optia组的绝对血小板损失（PL）和每升处理血液中的PL显著更低（分别为22.9(18.3 - 28.1)% 对33.6(26.5 - 41.1)%，P <.001以及3.7(3.1 - 4.5)% 对4.3(3.5 - 4.2)%，P =.01）。然而，粒细胞污染更高（4.5(1.3 - 36)% 对1.2(0.4 - 5.7)%，P <.001），并且Spectra Optia获得的产品血细胞比容更高（1(0.5 - 1.6)% 对0.3(0.2 - 0.5)%，P <.001），但对照射时间无影响。
在我们的研究中，Spectra Optia在为GVHD的ECP采集高产率和高纯度的MNC方面被证明是安全有效的。
