Passos-Coelho J L, Machado M A, Lúcio P, Leal-Da-Costa F, Silva M R, Parreira A
Instituto Português de Oncologia, Lisbon, Portugal.
J Hematother. 1997 Oct;6(5):465-74. doi: 10.1089/scd.1.1997.6.465.
To overcome the need for multiple leukaphereses to collect enough PBPC for autologous transplantation, large-volume leukaphereses (LVL) are used to process multiple blood volumes per session. We compared the efficiency of CD34+ cell collection by LVL (n = 63; median blood volumes processed 11.1) with that of standard-volume leukaphereses (SVL) (n = 38; median blood volumes processed 1.9). To achieve this in patients with different peripheral blood concentrations of CD34+ cells, we analyzed the ratio of CD34+ cells collected per unit of blood volume processed, divided by the number of CD34+ cells in total blood volume at the beginning of apheresis. For LVL, 30% (9%-323%) of circulating CD34+ cells were collected per blood volume compared with 42% (7%-144%) for SVL (p = 0.02). However, in LVL patients, peripheral blood CD34+ cells/L decreased a median of 54% during LVL (similar data for SVL not available). The number of CD34+ cells collected per blood volume processed after 4 and 8 blood volumes and at the end of LVL were 0.32 (0.01-2.05), 0.24 (0.01-1.68), and 0.22 (0.01-2.40) x 10(6) CD34+ cells/kg, respectively (p = 0.0007), despite the 54% decrease in peripheral blood CD34+ cells/L throughout LVL. A median 66% decrease in the platelet count was also observed during LVL. Thus, LVL may be more efficient than SVL for PBPC collection, allowing, in most patients, the collection in one LVL of sufficient PBPC to support autologous transplantation.
为了克服多次白细胞单采以收集足够的外周血祖细胞用于自体移植的需求，大容量白细胞单采（LVL）被用于每次处理多个血容量。我们比较了LVL（n = 63；处理的中位血容量为11.1）与标准容量白细胞单采（SVL）（n = 38；处理的中位血容量为1.9）采集CD34+细胞的效率。为了在不同外周血CD34+细胞浓度的患者中实现这一点，我们分析了每处理单位血容量采集的CD34+细胞与单采开始时全血中CD34+细胞数量的比值。对于LVL，每血容量采集30%（9%-323%）的循环CD34+细胞，而SVL为42%（7%-144%）（p = 0.02）。然而，在LVL患者中，白细胞单采期间外周血CD34+细胞/L中位数下降了54%（无法获得SVL的类似数据）。在处理4个和8个血容量后以及LVL结束时，每处理血容量采集的CD34+细胞数量分别为0.32（0.01-2.05）、0.24（0.01-1.68）和0.22（0.01-2.40）×10(6)个CD34+细胞/kg（p = 0.0007），尽管在整个LVL过程中外周血CD34+细胞/L下降了54%。在LVL期间还观察到血小板计数中位数下降了66%。因此，对于外周血祖细胞采集，LVL可能比SVL更有效，在大多数患者中，一次LVL采集就可以获得足够的外周血祖细胞来支持自体移植。
