Jo Tomoyasu, Yoshihara Satoru, Arai Yasuyuki, Ikemoto Junko, Onomoto Hitomi, Sugiyama Hiroki, Yoshihara Kyoko, Matsui Keiko, Niwa Norimi, Nakagawa Yoko, Kitawaki Toshio, Kanda Junya, Takaori-Kondo Akifumi, Nagao Miki
Department of Clinical Laboratory Medicine and Center for Research and Application of Cellular Therapy, Kyoto University Hospital.
Department of Hematology and Oncology, Kyoto University Hospital.
Rinsho Ketsueki. 2021;62(3):163-169. doi: 10.11406/rinketsu.62.163.
To perform chimeric antigen receptor T (CAR-T) cell therapy in heavily pretreated patients with progressive disease and depleted lymphocytes, an optimized leukapheresis protocol must be established. To probe the effects of patient-related parameters on the collection efficiency of CD3 cells, we retrospectively analyzed patients with relapsed/refractory diffuse large B-cell lymphoma who underwent leukapheresis for tisagenlecleucel at two centers. A total of 51 patients were analyzed, with a median age at apheresis of 59 years, and precollection hemoglobin levels, CD3 cell counts, and platelet counts of 9.2 g/dl, 574/µl, and 15.8×10/µl, respectively. A median of 3.0×10 (0.7-8.4) CD3 cells were harvested with 8.7 (4.0-15.7) l apheresis volume. The collection efficiency 2 (CE2) for CD3 cells was 61.0% (21.0-127.3). One-day apheresis was sufficient to obtain the designated cell numbers in all cases. Lower hemoglobin levels, higher CD3 cell counts, and higher platelet counts before apheresis were significantly associated with lower CE2 for CD3 cells. These results suggest a need to increase the apheresis volume in anemic, lymphocyte- or platelet-rich patients due to an expected low CE2. Erythrocyte transfusions before or during apheresis may be a reasonable option for patients with anemia.
对于病情进展且淋巴细胞耗竭的经大量预处理的患者进行嵌合抗原受体T（CAR-T）细胞治疗时，必须建立优化的白细胞分离方案。为了探究患者相关参数对CD3细胞采集效率的影响，我们回顾性分析了在两个中心接受替沙格韦单抗白细胞分离术的复发/难治性弥漫性大B细胞淋巴瘤患者。共分析了51例患者，采血时的中位年龄为59岁，采集前血红蛋白水平、CD3细胞计数和血小板计数分别为9.2 g/dl、574/µl和15.8×10/µl。中位采集量为8.7（4.0 - 15.7）升，收获3.0×10（0.7 - 8.4）个CD3细胞。CD3细胞的采集效率2（CE2）为61.0%（21.0 - 127.3）。在所有病例中，单日白细胞分离术足以获得指定的细胞数量。采集前血红蛋白水平较低、CD3细胞计数较高和血小板计数较高与CD3细胞的CE2较低显著相关。这些结果表明，由于预期采集效率较低，对于贫血、淋巴细胞或血小板丰富的患者需要增加白细胞分离量。在白细胞分离术前或术中进行红细胞输血可能是贫血患者的合理选择。
