Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Transfusion. 2019 May;59(5):1765-1772. doi: 10.1111/trf.15186. Epub 2019 Feb 12.
Adoptive immunotherapy using engineered lymphocytes has shown promising results in treating cancers even in patients who have failed other treatments. As the first essential step, the number of peripheral mononuclear cell (MNC) collection procedures is rapidly increasing. In this retrospective study, we reviewed the collection results to determine factors that affect MNC collection.
We reviewed 184 collections that were performed on 169 adult allogenic donors and patients with acute lymphoid leukemia, chronic lymphoid leukemia, lymphoma, multiple myeloma, or solid-organ tumors. All the leukapheresis procedures were performed after a complete cell count with differential was obtained. Total blood volume (TBV) was defined as processed blood volume divided by patient blood volume.
There was a significant association between the precollection MNC count (pre-MNC) and the MNC yields normalized by TBV (r = 0.926; p < 0.001) and a regression formula was created to predict MNC yields. Multiple regression analyses showed that pre-MNC, TBV, and precollection hemoglobin were strongly associated with MNC yield (R = 0.866; F (3180) = 388.472; p < 0.001), and pre-MNC had the greatest influence on MNC yield (β = 0.960; p < 0.001) followed by TBV (β = 0.302; p < 0.001), and Hgb (β = 0.136; p < 0.001).
Our results suggest that the optimal time for MNC collection can be determined based on pre-MNC and that processing volume should be determined based on collection goal and pre-MNC to optimize and personalize the harvesting procedure.
过继免疫疗法利用工程淋巴细胞在治疗癌症方面取得了有希望的结果,即使在其他治疗方法失败的患者中也是如此。作为第一步,外周血单个核细胞(MNC)的采集程序数量迅速增加。在这项回顾性研究中,我们回顾了采集结果,以确定影响 MNC 采集的因素。
我们回顾了 169 例成人同种异体供体和急性淋巴细胞白血病、慢性淋巴细胞白血病、淋巴瘤、多发性骨髓瘤或实体瘤患者的 184 次采集。所有白细胞分离术都是在获得完整的细胞计数和分类后进行的。总血容量(TBV)定义为处理的血液量除以患者的血液量。
采集前 MNC 计数(pre-MNC)与 TBV 标准化的 MNC 产量之间存在显著相关性(r=0.926;p<0.001),并创建了一个回归公式来预测 MNC 产量。多元回归分析显示,pre-MNC、TBV 和采集前血红蛋白与 MNC 产量密切相关(R2=0.866;F(3180)=388.472;p<0.001),pre-MNC 对 MNC 产量的影响最大(β=0.960;p<0.001),其次是 TBV(β=0.302;p<0.001)和 Hgb(β=0.136;p<0.001)。
我们的结果表明,可以根据 pre-MNC 来确定采集 MNC 的最佳时间,并且应该根据采集目标和 pre-MNC 来确定处理量,以优化和个性化采集过程。