通过新型自动白细胞分离系统改善动员的CD34+造血祖细胞的采集

Improved collection of mobilized CD34+ hematopoietic progenitor cells by a novel automated leukapheresis system.

作者信息

Ravagnani F, Siena S, De Reys S, Di Nicola M, Notti P, Giardini R, Bregni M, Matteucci P, Gianni A M, Pellegris G

机构信息

Division of Immunohematology and Medical Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.

出版信息

Transfusion. 1999 Jan;39(1):48-55. doi: 10.1046/j.1537-2995.1999.39199116894.x.

DOI:10.1046/j.1537-2995.1999.39199116894.x

PMID:9920166

Abstract

BACKGROUND

For simplification of blood cell transplantation, an automated apheresis system that exploits a dual-stage channel device for mononuclear cell (MNC) collection (AutoPBSC, designed for the COBE Spectra) was studied.

STUDY DESIGN AND METHODS

The automated default software (AutoPBSC-Default) and three software modifications of the harvest frequency during leukapheresis, referred to as AutoPBSC-1.25, AutoPBSC-1.75, and AutoPBSC-2.75, were evaluated in comparison with the semiautomated Version 4.7 (V4.7) apheresis system in 119 leukapheresis procedures performed in 90 cancer patients treated with chemotherapy plus granulocyte-colony-stimulating factor. CD34+ cell and platelet collection efficiency (CE); volume and cell composition of the leukapheresis components; and patient platelet and red cell (RBC) loss during leukapheresis were measured.

RESULTS

The majority of collection measures evaluated with the AutoPBSC compared favorably to those obtained with the V4.7. CD34+ cell CE increased from 55 percent with V4.7 to 68 percent with the AutoPBSC-Default (p = 0.05). The AutoPBSC provided lower platelet contamination in the collected component (1.18 x 10(11) vs. 2.26 x 10(11) with the V4.7; p<0.001). The volume of the AutoPBSC-Default component was significantly lower (67 vs. 180 mL with the V4.7; p<0.001). The MNC purity of the AutoPBSC component was greater (52 vs. 28% with the V4.7; p<0.001), and the RBC contamination lower (AutoPBSC, 0.53 x 10(11) vs. 1.04 x 10(11) with the V4.7; p<0.001). Modifications of the AutoPBSC to increase the harvest frequency by 1.25-, 1.75-, and 2.75-fold resulted in increased CD34+ cell CE (77%, 75%, and 83%, respectively; p<0.001 in all cases), but also in reduced numbers of circulating platelets, higher platelet contamination of the component, and lower MNC purity than were seen with the AutoPBSC-Default.

CONCLUSION

The AutoPBSC offers the following advantages over the V4.7 system: a) better CE of CD34+ cells; b) reduced collection of platelets; c) reduced contamination of the leukapheresis component with granulocytes, platelets, and RBCs; d) reduced component volume; and e) automation.

摘要

背景

为简化血细胞移植，研究了一种利用双阶段通道装置采集单核细胞（MNC）的自动单采系统（专为COBE Spectra设计的AutoPBSC）。

研究设计与方法

在90例接受化疗加粒细胞集落刺激因子治疗的癌症患者进行的119次白细胞单采过程中，将自动默认软件（AutoPBSC-Default）以及白细胞单采过程中采集频率的三种软件修改版本（分别称为AutoPBSC-1.25、AutoPBSC-1.75和AutoPBSC-2.75）与半自动4.7版（V4.7）单采系统进行比较。测量了CD34+细胞和血小板采集效率（CE）；白细胞单采成分的体积和细胞组成；以及白细胞单采过程中患者血小板和红细胞（RBC）的损失。

结果

与V4.7相比，使用AutoPBSC评估的大多数采集指标表现更优。CD34+细胞CE从V4.7的55%提高到AutoPBSC-Default的68%（p = 0.05）。AutoPBSC采集成分中的血小板污染更低（1.18×10¹¹ 对比V4.7的2.26×10¹¹；p<0.001）。AutoPBSC-Default成分的体积显著更低（67对比V4.7的180 mL；p<0.001）。AutoPBSC成分的MNC纯度更高（52%对比V4.7的28%；p<0.001），RBC污染更低（AutoPBSC为0.53×10¹¹ 对比V4.7的1.04×10¹¹；p<0.001）。将AutoPBSC的采集频率提高1.25倍、1.75倍和2.75倍的修改导致CD34+细胞CE增加（分别为77%、75%和83%；所有情况p<0.001），但也导致循环血小板数量减少、成分中血小板污染更高以及MNC纯度低于AutoPBSC-Default。