Adkins D, Spitzer G, Johnston M, Velasquez W, Dunphy F, Petruska P
Division of Bone Marrow Transplantation, Oncology and Hematology, Saint Louis University Health Sciences Center, Missouri, USA.
Transfusion. 1997 Jul;37(7):737-48. doi: 10.1046/j.1537-2995.1997.37797369451.x.
Granulocyte-colony-stimulating factor (G-CSF) is a safe and effective agent for mobilization of neutrophils in normal donors, consistently resulting in cell yields per leukapheresis (LA) procedure that are superior to those with other agents. LA components also contain platelets, whose clinical relevance is unknown.
This study describes the kinetics of and analyzes the factors determining the ANC and platelet count increments seen with each of three transfusions of granulocytes collected from HLA-matched sibling donors receiving G-CSF (n = 10; maximum of 3 LA procedures/donor). The transfusions were given to recipients (n = 10) on alternate days beginning. Day 1 after allogeneic bone marrow transplant (BMT).
Significant, sustained increments in the recipient ANCs were observed after the transfusion of G-CSF-mobilized LA components. The mean peak posttransfusion increments in the ANCs were 1195, 729, and 631 per microL with transfusion of donor LA components on Days 1, 3, and 5, respectively. The length of time that the mean posttransfusion ANC was at or above the baseline (pretransfusion) value was 25 to 37 hours, depending on the post-BMT day when the component was administered. No consistent relationship was observed between LA component granulocyte dose, baseline recipient ANC, or temperature elevation and post-transfusion ANC increments. Large numbers of platelets (mean, 2.55 x 10(11)) were present in LA components, and this resulted in significant increments from baseline in the mean platelet count 1 hour after LA component transfusions. Between Days 1 and 7, the duration of severe neutropenia was shorter and the percentage of patients requiring nondonor platelet transfusions was less in study patients who received LA component transfusions than in a similar historical control group who did not.
The transfusion of G-CSF-mobilized, HLA-matched LA components to allogeneic BMT recipients resulted in significant and sustained increments in the ANC and the platelet count. Within the range examined, a relationship between neutrophil dose and an increment in the ANC was not demonstrated.
粒细胞集落刺激因子（G-CSF）是一种用于动员正常供者中性粒细胞的安全有效药物，每次白细胞单采术（LA）所获得的细胞产量始终优于使用其他药物时。LA成分中还含有血小板，其临床相关性尚不清楚。
本研究描述了从接受G-CSF的HLA配型相合的同胞供者采集的粒细胞进行三次输血时中性粒细胞绝对计数（ANC）和血小板计数增加的动力学情况，并分析了决定这些增加的因素（n = 10；每位供者最多进行3次LA操作）。从异基因骨髓移植（BMT）后的第1天开始，每隔一天给受者（n = 10）进行输血。
输注G-CSF动员的LA成分后，受者的ANC出现显著、持续的增加。分别在第1、3和5天输注供者LA成分后，ANC的平均输血后峰值增加量分别为每微升1195、729和631。输血后ANC平均值达到或高于基线（输血前）值的时间长度为25至37小时，这取决于在BMT后第几天输注该成分。未观察到LA成分粒细胞剂量、受者基线ANC或体温升高与输血后ANC增加之间存在一致的关系。LA成分中存在大量血小板（平均为2.55×10¹¹），这导致输血后1小时平均血小板计数较基线有显著增加。在第1至7天，接受LA成分输血的研究患者中严重中性粒细胞减少的持续时间较短，且需要非供者血小板输血的患者百分比低于未接受输血的类似历史对照组。
向异基因BMT受者输注G-CSF动员的、HLA配型相合的LA成分可使ANC和血小板计数显著且持续增加。在所研究的范围内，未证明中性粒细胞剂量与ANC增加之间存在关系。
