Blood Transfusion Center Aarau, Swiss Red Cross, Kantonsspital Aarau AG, Aarau, Switzerland.
Institute of Laboratory Medicine, Kantonsspital Aarau AG, Aarau, Switzerland.
J Clin Apher. 2020 Jun;35(3):217-223. doi: 10.1002/jca.21782. Epub 2020 Apr 18.
Collection efficiency (CE) of peripheral blood stem cell (PBSC) collections is negatively affected by increasing white blood cell (WBC) counts of the patient. This study compared a new optimized mononuclear cell (MNC) collection protocol (OPP) to the standard MNC collection protocol recommended by the manufacturer (STP) for PBSC collection in patients with WBC counts >35 000/μL.
Single-center, retrospective, and observational study of 81 autologous PBSC collections on Fenwal Amicus cell separators in 70 adult patients.
Median peripheral WBC count (×10 /μL; 44.2 in OPP group vs 46.5 in STP group) and median CD34 count (105/μL in OPP group vs 40/μL in STP group) at the beginning of PBSC collection did not differ significantly. Median CE2 (45% vs 31%; P < .001) as well as CD34 yield of the apheresis product both with regards to median absolute CD34 content (×10 ; 793 vs 188; P = .001) as well as median CD34 content (×10 )/kg body weight (8.93 vs 2.51; P = .002) were significantly higher for the OPP. Overall, 18/21 (86%) patients with the OPP obtained their target CD34 amount with a single apheresis session, compared to 25/50 (50%) with the STP (P = .005). PBSC collections using OPP lasted significantly longer (median 377 minutes vs 260 minutes; P < .001) than with the STP.
The OPP significantly improves CE2 for PBSC collections on Fenwal Amicus cell separators in patients with pre-apheresis WBC counts >35 000/μL and significantly reduces the necessity for multiple apheresis sessions. The OPP is therefore suited to reduce both patient burden and cost in autologous PBSC collection.
外周血造血干细胞（PBSC）采集的采集效率（CE）会受到患者白细胞（WBC）计数增加的负面影响。本研究比较了一种新的优化的单核细胞（MNC）采集方案（OPP）与制造商推荐的标准 MNC 采集方案（STP），用于采集 WBC 计数>35000/μL 的患者的 PBSC。
这是一项在 70 名成年患者的 Fenwal Amicus 细胞分离机上进行的单中心、回顾性、观察性研究，共 81 例自体 PBSC 采集。
PBSC 采集开始时外周血 WBC 计数（×10/μL；OPP 组为 44.2，STP 组为 46.5）和 CD34 计数（OPP 组为 105/μL，STP 组为 40/μL）中位数无显著差异。CE2 中位数（45%比 31%；P<.001）以及相对于中位数绝对 CD34 含量（×10；793 比 188；P=.001）和中位数 CD34 含量（×10）/kg 体重（8.93 比 2.51；P=.002），OPP 组的采集产物中的 CD34 产量均显著更高。总体而言，18/21（86%）名接受 OPP 的患者通过单次单采即可获得目标 CD34 量，而接受 STP 的患者中只有 25/50（50%）例（P=.005）。使用 OPP 的 PBSC 采集持续时间明显长于 STP（中位数 377 分钟比 260 分钟；P<.001）。
在 Fenwal Amicus 细胞分离机上，对于 WBC 计数>35000/μL 的患者，OPP 可显著提高 PBSC 采集的 CE2，并显著降低多次单采的必要性。因此，OPP 适用于降低自体 PBSC 采集的患者负担和成本。
