Truong Tony H, Prokopishyn Nicole L, Luu Henry, Guilcher Gregory M T, Lewis Victor A
Department of Oncology and Pediatrics, Section of Pediatric Oncology, Blood and Marrow Transplant, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta.
Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta.
J Clin Apher. 2019 Oct;34(5):598-606. doi: 10.1002/jca.21738. Epub 2019 Aug 7.
Factors affecting the success of peripheral blood stem cell collection (SCC) in children are not well characterized. We reviewed 218 stem cell collections among 199 pediatric donors, of which 35 were from healthy sibling donors and 164 were for autologous collections. Successful SCC, defined as a CD34 cell count of ≥2 × 10 /kg of recipient weight per intended transplant, occurred in 188 of 199 donors (94%). Ideal SCC defined ≥5 × 10 CD34 cells/kg of recipient per intended transplant, occurred in 147 (74%) patients. Failure of collection occurred in 11 (6%) patients and was significantly associated with an autologous collection for a brain tumor diagnosis (P = .003) and a pre-apheresis peripheral blood (PB) CD34 count <20 × 10 cells/L (P = .002). Ideal SCC was significantly associated with age < 10 years (P = .01) and pre-apheresis PB-CD34 count ≥20 × 10 cells/L (P < .0001). Factors associated with failure of SCC may be identified in advance of the collection procedure allowing appropriate counselling of patients as well as anticipatory guidance for multiple collections or justify the preemptive use of stem cell mobilizing agents.
影响儿童外周血干细胞采集（SCC）成功的因素尚未得到充分描述。我们回顾了199名儿科供者的218次干细胞采集情况，其中35次来自健康的同胞供者，164次为自体采集。成功的SCC定义为每次预期移植时，每千克受者体重的CD34细胞计数≥2×10⁶，199名供者中有188名（94%）达到该标准。理想的SCC定义为每次预期移植时，每千克受者体重的CD34细胞计数≥5×10⁶，147名（74%）患者达到该标准。11名（6%）患者采集失败，这与因脑肿瘤诊断进行自体采集（P = 0.003）以及采集前外周血（PB）CD34计数<20×10⁶/L（P = 0.002）显著相关。理想的SCC与年龄<10岁（P = 0.01）以及采集前PB - CD34计数≥20×10⁶/L（P < 0.0001）显著相关。在采集程序之前可以确定与SCC失败相关的因素，从而为患者提供适当的咨询，并为多次采集提供预期指导，或证明提前使用干细胞动员剂的合理性。
