Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria.
Team Biostatistics and Big Medical Data, IDA Lab, Paracelsus Medical University Salzburg, Salzburg, Austria.
Blood Transfus. 2024 Mar;22(2):150-156. doi: 10.2450/BloodTransfus.442. Epub 2023 Jul 14.
Extracorporeal photopheresis (ECP) is a well-established but lengthy and burdensome cell-based therapy for various diseases such as cutaneous T-cell lymphoma, graft-versus-host disease and organ rejection after transplantation. The number of mononuclear cells (MNCs) that needs to be collected to obtain a clinical response to ECP is still under debate. The purpose of this retrospective study was to determine the number of lymphocytes, monocytes and neutrophils in mononuclear cell products (MCP) by flow cytometry and the collection efficiency in the offline ECP setting.
We collected data from 10 different patients undergoing 162 ECP procedures using the Spectra Optia device for MNC collection. White blood cell (WBC) count of MCP was determined using a hematology analyzer. MNCs were analyzed for CD45 and CD14 expression by flow cytometry to exactly determine the collected lymphocyte and monocyte fractions.
Collected MCP showed high cell yields with 55.3×10/kg MNCs and 41.1×10/kg lymphocytes. MCP were characterized by high MNC (81.3%) and low neutrophils (18.7%) percentage. Mean collection efficiency for WBCs and for MNCs was 23.9% and 62.0%, respectively. The MNC fraction showed a moderate to high correlation between peripheral blood cell count of patients and MCP count.
This study is one of a few reports showing the monocyte-to-lymphocyte relation in MCP for ECP determined by flow cytometry. In comparison to historical data from inline ECP, the offline ECP processing one total blood volume results in considerably higher cell yields. For this reason, and to reduce the burden on patients, we propose that the offline ECP processing time can be substantially reduced.
体外光分离（ECP）是一种成熟但冗长且繁琐的细胞治疗方法，可用于治疗多种疾病，如皮肤 T 细胞淋巴瘤、移植物抗宿主病和移植后器官排斥反应。获得 ECP 临床反应所需的单核细胞（MNC）数量仍存在争议。本回顾性研究的目的是通过流式细胞术确定单核细胞产物（MCP）中淋巴细胞、单核细胞和中性粒细胞的数量，并确定离线 ECP 设定中的采集效率。
我们收集了 10 名不同患者在使用 Spectra Optia 设备进行 162 次 MNC 采集过程中的数据。使用血液学分析仪测定 MCP 的白细胞（WBC）计数。通过流式细胞术分析 MNC 对 CD45 和 CD14 的表达，以准确确定所采集的淋巴细胞和单核细胞分数。
收集的 MCP 细胞产量高，MNC 为 55.3×10^6/kg，淋巴细胞为 41.1×10^6/kg。MCP 的特点是 MNC（81.3%）高，中性粒细胞（18.7%）低。WBC 和 MNC 的平均采集效率分别为 23.9%和 62.0%。MNC 分数与患者外周血细胞计数和 MCP 计数之间呈中度至高度相关性。
本研究是少数几篇通过流式细胞术显示 ECP 中 MCP 单核细胞与淋巴细胞关系的报告之一。与在线 ECP 的历史数据相比，离线 ECP 处理全血体积可产生更高的细胞产量。出于这个原因，并为了减轻患者的负担，我们建议可以大大缩短离线 ECP 处理时间。
