Be The Match Seatte Collection Center, National Marrow Donor Program, Seattle, Washington, USA.
New York Blood Center, Clinical Services, New York, New York, USA.
Transfusion. 2021 May;61(5):1518-1524. doi: 10.1111/trf.16370. Epub 2021 Mar 13.
Hematopoietic progenitor cell (HPC) and immune effector cell (IEC) therapies often require high doses of mononuclear cells (MNCs), whether CD34+ cells, lymphocytes, or monocytes. Cells for IEC can be sourced from HPC products. We thus examined potentially modifiable variables affecting collection efficiencies (CEs) of MNC subsets in HPC collection and also of the typically undesired cell types of platelets, granulocytes, and red cells, which hinder downstream processing. Finally, we sought to confirm previously indeterminate studies of the effect of an adjusted collect flow rate (CFR) on CD34+ CE.
We performed univariate and multivariate regression analyses of all 135 National Marrow Donor Program (NMDP) HPC collections in 2019 and compared these fixed CFR procedures to previous NMDP collections using adjusted CFRs.
Target cell CEs decreased with increasing peripheral blood (PB) concentration and were associated with different cell type locations within the MNC layer. CEs of undesired cell types varied with standard procedural parameters (inlet flow rate, whole blood processed, etc.). Interestingly, some CEs increased with preapheresis hematocrit. Finally, adjusting the CFR by PB MNC count improved MNC CE but not CD34+ CE.
Correlation of target cell CEs with their PB concentration and different cell type locations by depth within the MNC layer indicates the importance of investigating the compensatory fine-tuning of procedure variables to improve CE. Correlation of CEs with PB hematocrit, and CFR adjustment by a modified PB MNC and/or PB CD34 algorithm should be further explored. Adjusting standard procedural parameters may reduce product contamination.
造血祖细胞（HPC）和免疫效应细胞（IEC）疗法通常需要高剂量的单核细胞（MNC），无论是 CD34+细胞、淋巴细胞还是单核细胞。IEC 的细胞可以来源于 HPC 产品。因此，我们研究了可能影响 HPC 采集中 MNC 亚群采集效率（CE）以及血小板、粒细胞和红细胞等通常不理想的细胞类型的可调节变量，这些细胞类型会阻碍下游处理。最后，我们试图证实以前关于调整后的采集流速（CFR）对 CD34+CE 的影响的不确定研究。
我们对 2019 年所有 135 例国家骨髓捐献者计划（NMDP）HPC 采集进行了单变量和多变量回归分析，并将这些固定 CFR 程序与以前使用调整后的 CFR 的 NMDP 采集进行了比较。
目标细胞 CE 随外周血（PB）浓度的增加而降低，与 MNC 层内不同细胞类型的位置有关。不需要的细胞类型的 CE 随标准程序参数（入口流速、处理的全血等）而变化。有趣的是，一些 CE 随着预采集的红细胞压积而增加。最后，通过 PB MNC 计数调整 CFR 提高了 MNC CE，但没有提高 CD34+CE。
目标细胞 CE 与 PB 浓度及其在 MNC 层内深度的不同细胞类型位置之间的相关性表明，研究程序变量的补偿微调以提高 CE 的重要性。CE 与 PB 红细胞压积的相关性，以及通过修改后的 PB MNC 和/或 PB CD34 算法调整 CFR 应进一步探讨。调整标准程序参数可能会减少产品污染。
