Bojanic Ines, Besson Nelly, Vidovic Ivana, Cepulic Branka Golubic
Department of Transfusion Medicine and Transplantation Biology, University Hospital Center Zagreb, Zagreb, Croatia.
University of Applied Health Sciences Zagreb, Zagreb, Croatia.
J Clin Apher. 2019 Aug;34(4):407-415. doi: 10.1002/jca.21693. Epub 2019 Mar 4.
The number of CD34+ cells collected in apheresis procedures depends mainly on the collection efficiency of the device and the blood volume processed. Large volume leukapheresis (LVL) can improve CD34+ cell yield and has previously been investigated using the COBE Spectra device (Terumo BCT, USA).
This was a retrospective analysis of LVL performance in patients undergoing continuous mononuclear cell collection (CMNC) using the new Spectra Optia apheresis system (Terumo BCT, USA) at the University Hospital Center, Zagreb, from March 2016 to September 2016. CD34+ cell yield predictability, determined using a customized algorithm, was also assessed.
In total, 67 procedures performed in 46 adults and 14 performed in 11 children were included in the analysis. In adults, 30 (65.2%) patients successfully reached their target preapheresis CD34+ cell count on day 1, with a median (interquartile range [IQR]) CD34+ collected cell dose of 4.8 × 10 /kg (2.3-10.6 × 10 /kg). In the pediatric group, 81.8% successfully collected the target CD34+ cell dose on the first day, with a median (IQR) CD34+ collected cell dose of 11.1 × 10 /kg (3.2-16.3 × 10 /kg). The customized algorithm showed a strong and significant linear correlation with actual CD34+ cell dose (P < 0.0001).
The results of this study support the use of LVL and the customized prediction algorithm in apheresis procedures. The ability to tailor the procedure to meet the needs of the individual patient may help to minimize the blood volume processed, shorten the duration, reduce the volume of infused anticoagulants, and improve patient comfort.
在单采过程中收集的CD34+细胞数量主要取决于设备的采集效率和处理的血量。大容量白细胞单采（LVL）可提高CD34+细胞产量，此前已使用COBE Spectra设备（美国Terumo BCT公司）进行过研究。
这是一项对2016年3月至2016年9月在萨格勒布大学医院中心使用新型Spectra Optia单采系统（美国Terumo BCT公司）进行连续单核细胞采集（CMNC）的患者的LVL性能的回顾性分析。还评估了使用定制算法确定的CD34+细胞产量的可预测性。
分析共纳入了46名成人进行的67次操作和11名儿童进行的14次操作。在成人中，30名（65.2%）患者在第1天成功达到其目标单采前CD34+细胞计数，采集的CD34+细胞剂量中位数（四分位间距[IQR]）为4.8×10⁶/kg（2.3 - 10.6×10⁶/kg）。在儿科组中，81.8%的患者在第一天成功采集到目标CD34+细胞剂量，采集的CD34+细胞剂量中位数（IQR）为11.1×10⁶/kg（3.2 - 16.3×10⁶/kg）。定制算法与实际CD34+细胞剂量显示出强且显著的线性相关性（P < 0.0001）。
本研究结果支持在单采过程中使用LVL和定制预测算法。根据个体患者需求调整操作的能力可能有助于最小化处理的血量、缩短持续时间、减少输注抗凝剂的体积并提高患者舒适度。
