Mitterer M, Hirber J, Gentilini I, Prinoth O, Fabris P, Emmerich B, Coser P, Straka C
Department of Hematology, Bone Marrow Transplantation and Blood Transfusion Center, Bozen/Bolzano, Italy.
Bone Marrow Transplant. 1996 Sep;18(3):611-7.
Twenty-eight patients with different hematological diseases (17 non-Hodgkin's lymphoma, one Hodgkin's disease and 10 multiple myeloma) underwent peripheral blood progenitor cell (PBPC) collection after cyclophosphamide 7 g/m2 and rh-G-CSF. Fifty-eight leukaphereses were carried out with a fully automated PBPC collection procedure. Progenitor cell release was monitored by standardized determination of CD34+ cells in the peripheral blood. After a profound aplasia, a continuous increase in CD34+ cells in the peripheral blood was seen for at least 3-4 days. In 82% of our patients more than 2.5 x 10(6) CD34/kg could be collected using a standard apheresis of 10 l. There was a high correlation between the CD34+ cells in the peripheral blood and CD34+ cells/kg harvested. (r2 = 0.91). A relatively constant ratio (median 14.3, range 3.2-22.6) was found between CD34+ cells/kg and CFU-GM/kg. Based on the CD34 values of the pre-apheresis blood and the body weight of an individual patient and using the mathematical model of regression analysis (y = mx + b) for the correlation between the CD34+ cells/microliter in the pre-apheresis blood and the CD34+ cells/kg, it was possible to create a formula allowing for target value tailored apheresis. Using this formula, the blood volume which needs to be processed in order to harvest a desired number of CD34+ cells/kg can be calculated. This strategy can be applied to reduce the time for and the number of aphereses. Nineteen leukaphereses were carried out applying the formula. In 18 of 19 leukaphereses the expected CD34+/kg values were correctly achieved or exceeded. The formula was most reliable when the CD34 value was higher than 15/microliter and when the WBC count was below 20 x 10(9)/l in the pre-apheresis blood. For mobilizations using hematopoietic growth factors alone our formula is not applicable, because in most cases the pre-apheresis white blood cell count is higher than 20 x 10(9)/l and the collection efficacy of lymphomonocytoid cells decreases with a high pre-apheresis white blood cell count. The formula also works with other mobilization regimens that induce a pronounced aplasia.
28例患有不同血液系统疾病的患者（17例非霍奇金淋巴瘤、1例霍奇金病和10例多发性骨髓瘤）在接受7 g/m²环磷酰胺和重组人粒细胞集落刺激因子（rh-G-CSF）治疗后进行了外周血祖细胞（PBPC）采集。采用全自动PBPC采集程序进行了58次白细胞单采。通过对外周血中CD34⁺细胞进行标准化测定来监测祖细胞的释放。在严重再生障碍期后，外周血中CD34⁺细胞持续增加至少3 - 4天。在我们82%的患者中，使用10升的标准单采可以采集到超过2.5×10⁶个CD34⁺/kg细胞。外周血中的CD34⁺细胞与采集到的CD34⁺细胞/kg之间存在高度相关性（r² = 0.91）。在CD34⁺细胞/kg与粒-巨噬细胞集落形成单位（CFU-GM）/kg之间发现了一个相对恒定的比例（中位数为14.3，范围为3.2 - 22.6）。根据单采前血液的CD34值和个体患者的体重，并使用回归分析的数学模型（y = mx + b）来分析单采前血液中CD34⁺细胞/微升与CD34⁺细胞/kg之间的相关性，有可能创建一个公式来进行针对目标值的单采。使用这个公式，可以计算出为采集到所需数量的CD34⁺细胞/kg而需要处理的血量。这种策略可用于减少单采的时间和次数。应用该公式进行了19次白细胞单采。在19次白细胞单采中的18次中，预期的CD34⁺/kg值被正确达到或超过。当单采前血液中CD34值高于15/微升且白细胞计数低于20×10⁹/L时，该公式最为可靠。对于仅使用造血生长因子进行动员的情况，我们的公式不适用，因为在大多数情况下，单采前白细胞计数高于20×10⁹/L，且单采前白细胞计数较高时淋巴细胞样细胞的采集效率会降低。该公式也适用于其他诱导明显再生障碍的动员方案。
