Lee J H, Cullis H, Leitman S F, Klein H G
Department of Transfusion Medicine, National Institutes of Health, Bethesda, Maryland 20892, USA.
J Clin Apher. 1995;10(4):198-202. doi: 10.1002/jca.2920100408.
The efficacy of 6% hydroxyethyl starch (hetastarch, HS) in enhancing granulocyte harvest by centrifugal leukapheresis has been described by a simple equation which predicts the granulocyte collection efficiency (GCE) based on an intrinsic donor variable, the erythrocyte sedimentation rate (ESR): GCE(%) = 1.3 ESR (mm/hr) + 45. Ten percent low molecular weight hydroxyethyl starch (pentastarch, PS) has been reported to be as effective as HS with potentially fewer adverse donor reactions (ADR). The derivation of an analogous equation for PS under conditions previously reported for HS may quantify PS efficacy and allow comparison to HS. We prospectively measured the in vitro and the in vivo effects of PS on the donor ESR in 53 granulocyte collections from 44 donors using the model CS-3000 Plus blood cell separator (CS). We then correlated the findings with the GCE of each procedure and derived an equation which expresses GCE in terms of baseline donor ESR. The in vitro addition of PS increased the donor ESR 2.4-fold, but its administration to a donor during a collection procedure did not appreciably change the ESR. Higher baseline donor ESR was more likely to result in more efficient cell collections: GCE (%) = 0.8 ESR (mm/hr) + 20; (r = 0.37). For granulocyte harvests using the CS and PS as the sedimenting agent 1) baseline donor ESR affects granulocyte harvests, but the poor correlation does not allow an accurate prediction of GCE and cell yield from the baseline donor ESR; 2) in comparison with HS (results from a previous study), PS may be less effective in vitro and not effective in vivo in elevating ESR, and may be less effective in enhancing granulocyte harvest; and 3) the parameters (slope, y-intercept, correlation coefficient) which define the linear relationship between baseline donor ESR and GCE may serve collectively as a quantitative measure of the effectiveness of different hydroxyethyl starch agents in enhancing granulocyte harvests. These parameters may be helpful in rapidly assessing the clinical efficacy of new, potentially useful hydroxyethyl starch agents prior to initiating a randomized, controlled clinical trial.
6%羟乙基淀粉（贺斯，HS）通过离心白细胞单采术提高粒细胞采集量的疗效已由一个简单公式描述，该公式基于一个内在供体变量——红细胞沉降率（ESR）来预测粒细胞采集效率（GCE）：GCE（%）=1.3 ESR（mm/小时）+45。据报道，10%低分子质量羟乙基淀粉（喷他淀粉，PS）与HS效果相当，且潜在的供体不良反应（ADR）可能更少。在先前报道的HS条件下推导PS的类似公式，可量化PS的疗效并与HS进行比较。我们使用CS - 3000 Plus血细胞分离机（CS）对44名供体的53次粒细胞采集进行前瞻性测量，观察PS对供体ESR的体外和体内影响。然后我们将这些结果与每个操作的GCE相关联，并推导了一个根据供体基线ESR表示GCE的公式。体外添加PS可使供体ESR增加2.4倍，但在采集过程中给供体使用PS并不会明显改变ESR。较高的供体基线ESR更有可能导致更高效的细胞采集：GCE（%）=0.8 ESR（mm/小时）+20；（r = 0.37）。对于使用CS和PS作为沉降剂的粒细胞采集，1）供体基线ESR影响粒细胞采集，但相关性较差，无法根据供体基线ESR准确预测GCE和细胞产量；2）与HS（先前一项研究的结果）相比，PS在体外升高ESR的效果可能较差，在体内无效，且在提高粒细胞采集量方面可能效果较差；3）定义供体基线ESR与GCE之间线性关系的参数（斜率、截距、相关系数）可共同作为不同羟乙基淀粉制剂提高粒细胞采集量有效性的定量指标。这些参数可能有助于在开展随机对照临床试验之前快速评估新型潜在有用羟乙基淀粉制剂的临床疗效。
