Division of Transfusion, Okayama University Hospital, Okayama, Japan.
Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan.
Transfusion. 2023 Jul;63(7):1344-1353. doi: 10.1111/trf.17450. Epub 2023 Jun 9.
Granulocyte transfusion therapy is a rational therapeutic option for patients with prolonged, severe neutropenia. Although high molecular weight hydroxyethyl starch (hHES) facilitates the separation of red blood cells during granulocyte collection, renal dysfunction has been noted as a potential side effect. HES130/0.4 (Voluven®) is a medium molecular weight HES (mHES) with superior safety profiles compared to hHES. Although HES130/0.4 is reportedly effective in the collection of granulocytes, we lack studies comparing the efficiency of granulocyte collection using HES130/0.4 and hHES.
We retrospectively collected the data from 60 consecutive apheresis procedures performed on 40 healthy donors at the Okayama University Hospital between July 2013 and December 2021. All procedures were performed using the Spectra Optia system. Based on the HES130/0.4 concentration in the separation chamber, granulocyte collection methods using HES130/0.4 were classified into m0.46, m0.44, m0.37, and m0.8 groups. We used HES130/0.4 and hHES groups to compare the various sample collection methods.
The median granulocyte collection efficiency (CE) was approximately 24.0% and 28.1% in the m0.8 and hHES groups, respectively, which were significantly higher than those in the m0.46, m0.44, and m0.37 groups. One month following granulocyte collection with HES130/0.4, no significant changes were observed in serum creatinine levels compared to those before the donation.
Therefore, we propose a granulocyte collection approach employing HES130/0.4, which is comparable to the use of hHES in terms of the granulocyte CE. A high concentration of HES130/0.4 in the separation chamber was considered crucial for granulocyte collection.
粒细胞输注疗法是治疗中性粒细胞减少症时间延长、严重程度重的患者的合理治疗选择。虽然高分子量羟乙基淀粉(hHES)有利于在粒细胞采集过程中分离红细胞,但肾功能障碍已被认为是一种潜在的副作用。HES130/0.4(Voluven®)是一种中分子羟乙基淀粉(mHES),与 hHES 相比具有更好的安全性。尽管据报道 HES130/0.4 在粒细胞采集方面有效,但我们缺乏比较使用 HES130/0.4 和 hHES 进行粒细胞采集效率的研究。
我们回顾性地收集了 2013 年 7 月至 2021 年 12 月期间在冈山大学医院进行的 60 次连续单采程序中 40 名健康供体的数据。所有程序均使用 Spectra Optia 系统进行。根据分离室中 HES130/0.4 的浓度,将使用 HES130/0.4 的粒细胞采集方法分为 m0.46、m0.44、m0.37 和 m0.8 组。我们使用 HES130/0.4 组和 hHES 组来比较各种样本采集方法。
m0.8 组和 hHES 组的中位粒细胞采集效率(CE)分别约为 24.0%和 28.1%,明显高于 m0.46、m0.44 和 m0.37 组。与捐献前相比,使用 HES130/0.4 采集粒细胞后 1 个月,血清肌酐水平无明显变化。
因此,我们提出了一种使用 HES130/0.4 的粒细胞采集方法,其与使用 hHES 的粒细胞 CE 相当。分离室中 HES130/0.4 的高浓度被认为是粒细胞采集的关键。