Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 6N119, 10 Center Drive, 20892, Bethesda, MD, USA.
Saint Agnes Cancer Institute, Baltimore, MD, USA.
J Transl Med. 2022 Nov 8;20(1):519. doi: 10.1186/s12967-022-03708-w.
Chronic graft-versus-host disease (GVHD) is a major cause of late morbidity and non-relapse mortality in recipients of allogeneic hematopoietic cell transplantation (HCT). Its biology, however, remains poorly understood, making the studies of its biology and immunomodulatory therapies a difficult task. Such research is often hampered by lymphopenia which is common in these patients and precludes studies of critical cellular subsets across the spectrum of severity of disease. This study explores the potential of leukapheresis to safely acquire and efficiently store immune cells for immunology research in chronic GVHD.
This is a cross-sectional study in which 132 consecutively accrued patients undergo optional research leukapheresis and a one-week comprehensive outpatient evaluation. Baseline clinical and laboratory data and efficiency of the procedure were reported.
Ninety-four of 132 patients (71%) achieved the goal collection of 2 × 10^9 PBMNCs with a mean volume processed of 4.6 L. Only mild decreases in hemoglobin, platelet, lymphocyte and monocytes were observed. All adverse events were mild (grade 1) and had resolved by the time of discharge from the apheresis unit.
This study demonstrates feasibility, safety, and efficiency of research leukapheresis in a frail patient population. Results presented promote leukapheresis as a standard research practice option in studies of chronic GVHD in humans which may expedite advances in our understanding of this complex multisystem disease.
慢性移植物抗宿主病（GVHD）是异基因造血细胞移植（HCT）受者晚期发病和非复发死亡的主要原因。然而，其生物学特性仍知之甚少，这使得对其生物学和免疫调节治疗的研究变得困难。这种研究常常受到这些患者常见的淋巴细胞减少症的阻碍，而淋巴细胞减少症妨碍了对疾病严重程度范围内关键细胞亚群的研究。本研究探讨了白细胞分离术在慢性 GVHD 免疫研究中安全获取和有效储存免疫细胞的潜力。
这是一项横断面研究，其中 132 例连续入组的患者接受了可选的研究性白细胞分离术和为期一周的综合门诊评估。报告了基线临床和实验室数据以及该程序的效率。
132 例患者中有 94 例（71%）达到了采集 2×10^9 个外周血单个核细胞（PBMNCs）的目标，平均处理体积为 4.6 L。仅观察到血红蛋白、血小板、淋巴细胞和单核细胞的轻度下降。所有不良事件均为轻度（1 级），并在白细胞分离单位出院时已缓解。
本研究证明了在脆弱患者群体中进行研究性白细胞分离术的可行性、安全性和效率。目前的研究结果表明，白细胞分离术可作为慢性 GVHD 人类研究中的一种标准研究实践选择，这可能会加速我们对这种复杂多系统疾病的理解。
