Koç O N, Gerson S L, Phillips G L, Cooper B W, Kutteh L, Van Zant G, Reece D E, Fox R M, Schupp J E, Tainer N, Lazarus H M
Department of Medicine and CWRU Ireland Cancer Center, University Hospitals of Cleveland and CWRU, OH 44106, USA.
Bone Marrow Transplant. 1998 Feb;21(4):337-43. doi: 10.1038/sj.bmt.1701096.
In order to demonstrate the feasibility of mobilization, enrichment and engraftment of autologous peripheral blood CD34+ cells in patients with relapsed lymphoma, 59 peripheral blood progenitor cell (PBPC) collections from 21 patients were enriched for CD34+ cells using CEPRATE SC (CellPro, Bothell, WA, USA) immunoaffinity column. Following high-dose chemotherapy, a mean of 17 x 10(8) (range, 3-34) nucleated cells/kg containing 8.7 x 10(6) (0.3-26) CD34+ cells/kg were re-infused. Blood cell recovery in these patients was compared to engraftment capacity of unenriched PBPCs in a cohort of lymphoma patients treated with an identical high-dose chemotherapy regimen. Neutrophil and platelet engraftment was rapid in both groups including five patients who received < or = 1 x 10(6) CD34+ cells/kg. After infusion of CD34+ enriched cells, neutrophils exceeded 0.5 x 10(9)/l in 11 (8-14) days and platelets exceeded 20 x 10(9)/l (untransfused) in 15 (9-39) days. In order to optimize the immunoaffinity column utilization we stored the first PBPC collections overnight at 4 degrees C and combined them with the next day's collection prior to the CD34+ enrichment procedure in 11 patients. This maneuver resulted in a significant decrease in the CD34+ cell recovery (resulting in reinfusion of a mean of 42% less CD34+ cells). Although overnight storage did not affect neutrophil engraftment, platelet engraftment was prolonged in this group of patients even when > 2.0 x 10(6) CD34+ cells/kg were re-infused. The overnight storage procedure should be further evaluated for its effects on the CD34+ immunoaffinity enrichment procedure, megakaryocyte progenitors and platelet engraftment. We conclude that CD34+ cells enriched from peripheral blood result in rapid engraftment after high-dose chemotherapy in patients with advanced lymphoma that is comparable to that of patients receiving unenriched PBPCs.
为了证明动员、富集和植入复发淋巴瘤患者自体外周血CD34+细胞的可行性，使用CEPRATE SC（CellPro，美国华盛顿州博塞尔）免疫亲和柱对21例患者的59次外周血祖细胞（PBPC）采集物进行CD34+细胞富集。在大剂量化疗后，平均每千克体重回输17×10⁸（范围3 - 34）个有核细胞，其中含8.7×10⁶（0.3 - 26）个CD34+细胞/千克。将这些患者的血细胞恢复情况与一组接受相同大剂量化疗方案的淋巴瘤患者中未富集PBPC的植入能力进行比较。两组患者中性粒细胞和血小板的植入都很快，包括5例接受≤1×10⁶个CD34+细胞/千克的患者。输注富集CD34+细胞后，中性粒细胞在11（8 - 14）天超过0.5×10⁹/升，血小板在15（9 - 39）天超过20×10⁹/升（未输血）。为了优化免疫亲和柱的利用，我们将11例患者的首次PBPC采集物在4℃下过夜保存，并在进行CD34+富集程序之前将其与次日的采集物合并。这一操作导致CD34+细胞回收率显著降低（导致回输的CD34+细胞平均减少42%）。尽管过夜保存不影响中性粒细胞植入，但即使回输>2.0×10⁶个CD34+细胞/千克，该组患者的血小板植入仍延长。应进一步评估过夜保存程序对CD34+免疫亲和富集程序、巨核细胞祖细胞和血小板植入的影响。我们得出结论，外周血富集的CD34+细胞在晚期淋巴瘤患者大剂量化疗后导致快速植入，这与接受未富集PBPC的患者相当。
