Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Transfusion. 2020 Apr;60(4):779-785. doi: 10.1111/trf.15711. Epub 2020 Feb 17.
Plerixafor should be administered 6 to 11 hours before starting leukocytapheresis. However, we have been using plerixafor followed by leukocytapheresis according to different time schedules since 2007. Our objective was to compare the CD34+ cell collection efficiency (CE1) of the first leukocytapheresis performed after using plerixafor at different time intervals.
Same-day schedule refers to the administration of plerixafor at 10:00 AM and starting the leukocytapheresis on the same day at 4:00 PM (6 hours interval). Next-day schedule refers to the administration of plerixafor at 8:00 PM and starting the leukocytapheresis on the next day (10:00 AM or 4:00 PM; either a 14- or 20-hr interval). Variables that might influence the CE1 of CD34+ cells were analyzed by longitudinal linear regression with a random effects model derived by generalized estimating equations.
The median CE1 of CD34+ cells was higher in the group of 30 patients who underwent leukocytapheresis on the same day when compared with the group of 62 patients who underwent leukocytapheresis on the next day (65.8% vs. 56.7%; p < 0.01). In the longitudinal linear regression analysis, only the time from plerixafor administration to leukocytapheresis start was associated with a statistically significant decrease in the CE1 of CD34+ cells (CE1 change -0.034%; p < 0.01).
Higher CE1 of CD34+ cells was observed when patients underwent leukocytapheresis on the same day after receiving plerixafor in comparison with administering plerixafor and underwent leukocytapheresis on the next day. Larger studies are necessary to confirm present results.
培洛昔芬应在开始白细胞去除术前 6 至 11 小时内给药。然而，自 2007 年以来，我们一直在根据不同的时间表使用培洛昔芬，随后进行白细胞去除术。我们的目的是比较不同时间间隔使用培洛昔芬后首次白细胞去除术的 CD34+细胞采集效率（CE1）。
同日方案是指上午 10:00 给予培洛昔芬，并在同日下午 4:00 开始白细胞去除术（6 小时间隔）。次日方案是指晚上 8:00 给予培洛昔芬，并在次日（上午 10:00 或下午 4:00）开始白细胞去除术（14 或 20 小时间隔）。通过广义估计方程得出的随机效应模型的纵向线性回归分析了可能影响 CD34+细胞 CE1 的变量。
与次日行白细胞去除术的 62 例患者相比，同日行白细胞去除术的 30 例患者的 CD34+细胞 CE1 中位数更高（65.8% vs. 56.7%；p<0.01）。在纵向线性回归分析中，只有从培洛昔芬给药到白细胞去除术开始的时间与 CD34+细胞 CE1 的统计学显著下降相关（CE1 变化 -0.034%；p<0.01）。
与次日给予培洛昔芬并进行白细胞去除术相比，患者在接受培洛昔芬后同日行白细胞去除术时观察到更高的 CD34+细胞 CE1。需要更大的研究来证实目前的结果。
